1. Introduction
Although most human pathologies have been modeled using mammalian systems, such as mice, in recent years, attention has focused on the tropical freshwater fish Danio rerio (zebrafish, ZF) as an outstanding tool for studying human diseases [
1]. ZF models are now a well-known option for implementing personalized medicine strategies, along with other models of patient-derived xenografts or patient-derived organoids [
2,
3,
4,
5,
6]. ZF models are small and robust, cheap to maintain, and a single matching produces hundreds of eggs that develop extremely rapidly. An incomparable and unique feature is their optical transparency, which is important for easy visualization of the xenotransplanted cells or the biodistribution of the subject matter of research, or both simultaneously, with the aid of a fluorescence microscope and with high throughput results [
7].
Various injection sites were tested [
8,
9,
10], but the yolk sac [
8,
11,
12] has been shown to be an ideal approach for localized xenotransplantation in 2-day-old embryos, and in parallel, the Cuvier’s duct is the best option for delivering substances into the embryo’s bloodstream [
13]. On this basis, ZF represents an innovative tool in the research landscape to study cancer diseases [
14], including pediatric cancers such as pediatric B-cell malignancies. Although the treatment of pediatric B-cell malignancies can be considered a success story, with current overall survival (OS) of ~80% in the United States, the therapy-related side effects are still alarming [
15]. For this reason, in the last years, researchers’ interest has more frequently been focused on the development of a strategy that combines the knowledge about drugs with newborn nano-carriers for effective and selective drug delivery. In this context, polymeric NPs with well-defined size and shape, such as those synthesized using the polymers polylactide-
co-glycolide acid (PLGA) and poly (vinyl alcohol) (PVA) [
16] can improve the drug delivery process, thanks to the encapsulation of the drug that protects it until the nano-vector reaches the target through the enhancer permeability and retention (EPR) effect and releases its contents, leading to a reduction in the severe side effects associated with the use of chemotherapeutic agents [
17,
18]. In this context, ZF is an ideal candidate to rapidly evaluate xenograft tumor development, including the development of a B-cell malignancy model implanted in a large number of animals, and to investigate and potentially compare novel therapeutic approaches during their initial characterization [
19].
In the present study, we propose a fluorescent-based quantification method for the setup of a B-cell malignancy model in ZF embryos using Nalm-6 cells, a B-acute lymphoblastic leukemia (ALL)-like cell line. The developed Nalm-6 cell line model in ZF was employed to investigate the capability of PLGA-PVA polymeric NPs to reach the tumor site, as well as the killing capability of doxorubicin-loaded PLGA-PVA polymeric NPs. We found that PLGA-PVA polymeric NPs distribute in the ZF bloodstream and reach the tumor, and doxorubicin-loaded PLGA-PVA polymeric NPs are capable of killing Nalm-6 cells, thus reducing tumor cell burden.
2. Materials and Methods
2.1. PLGA-PVA Polymeric NPs Synthesis
PLGA-PVA polymeric NPs were produced in our laboratory with small modifications to the Vasir and Labhasetwar protocol [
16]. Firstly, the PLGA (Sigma, Saint Louis, MO, USA) solution was prepared by dissolving 30 mg of PLGA in 1 mL of chloroform (Sigma) in a 5 mL glass vial with magnetic stirring. During this process, the solution for the aqueous core of NPs was prepared, and fluorescein-5-isothiocyanate (FITC)-conjugated Bovine Serum Albumin (BSA, Sigma) or doxorubicin (Pfizer Inc. New York, NY, USA) was mixed in Tris-EDTA buffer. Finally, the PVA (Sigma) solution was set; 0.2 g of PVA was sprinkled slowly over 10 mL of cold Tris-EDTA buffer, centrifuged at 200×
g for 10 min at 4 °C, and 10 μL of chloroform was then added to saturate the PVA solution.
The solution for the core was added to the PLGA solution in two aliquots of 100 μL each, vortexed for 1 min after each addition, and sonicated. This primary emulsion was added in two portions to 6 mL of PVA solution and vortexed for 1 min after each addition. The resulting emulsion was stirred overnight (at RT) to allow chloroform to evaporate. NPs were recovered by ultracentrifugation at 11,000× g for 20 min at 4 °C, and the pellet was resuspended in 5 mL of Tris-EDTA buffer. The sample was washed again and resuspended in H2O MilliQ filtered 0.2 μm.
2.2. PLGA-PVA Polymeric NPs Characterization
NPs (5 μL) were diluted in 995 μL of H2O MilliQ filtered 0.2 μm and then analyzed through Dynamic Light Scattering (DLS). Instead, for morphological analysis, NPs (10 μL) were diluted 1:1 v/v with H2O MilliQ filtered 0.2 μm, and a drop of the sample was then deposited on a carbon screen coated with copper; after evaporation of the excess water, transmission electron microscopy (TEM) analysis was performed.
The NPs encapsulation efficiency was indirectly quantified by exploiting the intrinsic fluorescence of the FITC-BSA (maximum excitation/emission 495/521 nm) or doxorubicin (maximum excitation/emission 470/560 nm). The fluorescence signal corresponding to the unencapsulated compound was subtracted from that relating to the starting amount added. Then, an interpolation analysis with the FITC-BSA or doxorubicin standard curve was performed. The fluorescence signal was acquired with the ChemiDoc Imaging System (Bio-Rad, Hercules, CA, USA). The encapsulation efficiency was extrapolated by setting as 100% reference the fluorescent signal given by the starting amount of the compounds.
For NPs binding/internalization studies, 250,000 Nalm-6 cells were centrifuged at 400 rcf for 5 min and resuspended in 500 μL of culture medium (RPMI-1640, Sigma; supplemented with 10% of Fetal Bovine Serum, Sigma; 100 U/mL Penicillin/0.1 mg/mL Streptomycin, Sigma; 1% L-Glutamine, Sigma). Nalm-6 cells were incubated at 37 °C with increasing amounts (1, 2, and 4 μL) of FITC -BSA (Sigma)-NPs under shaking (800 rpm). At the end of incubation, cells were washed twice in Phosphate-Buffered Saline (PBS) and resuspended with 1% Paraformaldehyde (Sigma) diluted in PBS supplemented with 2% of BSA (Sigma), 0.7 mM CaCl2, and 0.7 mM MgCl2. The binding/internalization on the surface of cells was evaluated by flow cytometric analysis performed by an Attune® NxT Acoustic Focusing flow cytometer (Thermo Fisher Scientific, Waltham, MA, USA), acquiring 10,000 events; data were analyzed with Attune NxT Software (version 2.7, Thermo Fisher Scientific, Waltham, MA, USA).
2.3. MTT Viability Assay
Nalm-6 cells (200,000/200 μL of culture medium, RPMI-1640, Sigma; supplemented with 10% of Fetal Bovine Serum, Sigma; 100 U/mL Penicillin/0.1 mg/mL Streptomycin, Sigma; 1% L-Glutamine, Sigma) were incubated for 24 h at 37 °C under shaking (800 rpm) with free drugs (1μM of doxorubicin, Pfizer) or NPs (1μM of encapsulated drug for doxorubicin-loaded NPs and the same amount for FITC-BSA-NPs). Then, cells were resuspended in 200 μL of clear culture medium. Later, 20 μL of MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide, MTT, Sigma) was added, and samples were incubated for 4 h at 37 °C under shaking (800 rpm). Samples were then centrifuged for 3 min at 20,000 rcf. The supernatant was discarded, and the deposited crystals were solubilized in 200 μL of Dimethylsulfoxide (DMSO, Sigma). The optical density (OD) was measured at 570 nm with ELISA Reader TECAN Infinite M200. The percentage of viable cells was calculated using untreated cells as a reference for 100% viable cells.
2.4. Cell Labeling
Nalm-6 cells were labeled with CellTraceTM Calcein Red-Orange-AM (Thermo-Fisher Scientific, maximum excitation/emission 577/590 nm) according to the manufacturer’s instructions. Afterward, for the CD19 antigen expression analysis, cells were incubated with the primary mouse anti-human CD19 antibody (Immunotools, Gladiolenweg, Friesoythe, Germany, final concentration 5 ng/μL). The secondary Alexa 488-conjugated anti-mouse antibody (2 ng/μL, Invitrogen, Carlsbad, CA, USA) was used to reveal bound antibodies. The cell viability and the antigen expression were evaluated by an Attune® NxT Acoustic Focusing flow cytometer (Thermo Fisher Scientific), acquiring 10,000 events; data were analyzed with Attune NxT Software. The same analysis was performed by immunofluorescence; cells were cytocentrifuged on a slide, and nuclei were stained with 4′,6-diamidino-2-phenylindole (DAPI, Sigma). Slides and images were analyzed, respectively, using fluorescence microscope Nikon Eclipse Ti-E live system and Image-J software (version 2.3.0/1.53f, GNU General Public License, Bethesda, MD, USA).
2.5. In Vivo Studies
All experimental procedures involving animals were done after Ministerial Approval 04086.N.SGL.
Zebrafish eggs were placed in E3 Medium supplemented with methylene blue 0.5% and incubated at 28 °C, and 24 h after fertilization (hpf), the eggs were manually dechorionated. Embryos were then placed in E3 Medium supplemented with 1-phenyl 2-thiourea (PTU, Sigma, final concentration 0.2 mM) to inhibit the production of melanin.
2.5.1. Biodistribution Studies
NPs biodistribution studies were performed by injecting NPs (4.6 nL/embryo) in the duct of Cuvier of anesthetized embryos (tricaine, Sigma, final concentration 0.02%) using capillary glasses and a Nanoject II Auto-Nanoliter Injector (Drummond Scientific Co., Broomall, PA, USA). The entire process was conducted using a SteREO Microscope Discovery.V8 (Zeiss, Oberkochen, Germany, UE). At 24 h post-injection (hpi), the biodistribution of the NPs was evaluated using the fluorescence microscope Nikon Eclipse Ti-E live system; then, images were analyzed with Image-J software.
2.5.2. Xenograft Model
Forty-eight hpf embryos were anesthetized using tricaine (Sigma) and placed on agarose plates, and the excess water was removed to facilitate injection. Then, ~500 cells/embryo were injected in a final volume of 4.6 nL (final concentration 0.1 cell/μL) using Nanoject II Auto-Nanoliter Injector (Drummond Scientific). The localized model was set up by injecting cells in the perivitelline space and the diffused ones by injecting cells in the duct of Cuvier. The entire process was conducted using a SteREO Microscope Discovery.V8 (Zeiss). After cell injection, the embryos were kept at 30 °C and evaluated using the fluorescence microscope Nikon Eclipse Ti-E live system. Images were analyzed with Image-J software.
4. Discussion
In this study, a fluorescent-based quantification method was developed to evaluate the number of tumor cell line cells in ZF models. In particular, a localized xenograft model of B-ALL in ZF was developed using Nalm-6 cells. In this context, a variety of features made ZF an excellent model organism. These include primarily economic advantages due to its small size requiring low space and maintenance costs [
21]. Moreover, the genome is completely sequenced, shows a high level of similarity with humans (approximately 70%), and is easily manipulated [
22]. This made it possible to create transgenic or mutant ZF lines to facilitate the observation of internal structures or biological processes. An example is the Casper mutants, which maintain the body transparency of the embryonic stage until adulthood. There are also reporter lines, such as tg (fli1a:eGFP) and mpeg1.1:mCherry, which specifically respectively label endothelial cells and macrophages [
23]. From the reproductive perspective, ZF represents an excellent experimental system since it can lay about 200 eggs per mating. Thus, having a large number of embryos guarantees the possibility of conducting large studies. There are also significant development considerations that exhibit optimal experimental properties [
21].
Xenotransplantation represents a way to model tumor development and then study possible therapeutic approaches. ZF embryos represent a powerful model for cancer research, with a growing appreciation for their efficiency. Particularly, the transparent body wall and the absence of the immune response make ZF embryos optimal for xenograft as a tool to evaluate cancer progression and drug screening. Initial evidence of this was reported in 2005, when Lee et al. engrafted a human melanoma cell line in ZF, demonstrating the survival and migration of exogenous cells [
23]. Over the years, ZF then acquired importance, joining the common murine models. Although the latter remain the “gold standard”, limitations such as high costs, greater complexity, and the need for immunosuppression for xenograft make this system less flexible [
24]. In contrast, there are advantages to the experimental practicality of ZF. Firstly, being transparent, the clear and simple observation of transplanted cells is guaranteed by employing microscopy techniques. Indeed, immediately after the injection, it is possible to observe the embryos under a microscope and follow them over time to evaluate any changes (e.g., tumor mass formation). Moreover, the use of transgenic lines and labeled transplanted cells help the study of the developmental process of the tumor [
21]. All these observations demonstrate the interesting role of ZF xenotransplantation in studying tumor development and validating therapy efficacy. Starting from these considerations, ZF embryos can be used to test “next-generation” approaches such as NPs, which owe their success in drug delivery to the possibility of overcoming problems in cancer therapy-related, off-target side effects.
The treatment of pediatric cancers has been a success story, with current OS of ~80% in the United States. Nonetheless, this success has occurred at a significant price; with increased long-term cancer survivorship, there are also side effects. The most relevant is cardiovascular toxicity, which became apparent soon after the widespread use of anthracyclines in the 1970s. Several years after their discovery, these drugs continue to evoke considerable interest in basic science and clinical trial research [
25,
26,
27]. In fact, anthracycline chemotherapy regimens play a prominent role in many cancer treatments, e.g., 50 to 60% of childhood cancer survivors are treated with an anthracycline regimen to the point that anthracyclines are listed among the World Health Organization (WHO) model list of essential medicines [
28].
Despite their widely acknowledged efficacy, significant restrictions are associated with anthracycline treatment; the chemotherapy intensity has been raised to the limit of tolerance; therefore, there is a need for novel therapeutic approaches that are able to further improvement in outcomes and reduction in adverse effects [
29].
NPs represent an alternative approach that is supposed to be more specific thanks to the possibility of treating the pathology through encapsulated chemotherapy that reaches the desired site, where they release the content.
The nanostructures developed in this study were made of PLGA-PVA polymers, which have been widely investigated to formulate biodegradable devices for the sustained delivery of drugs, proteins, and nucleic acids. Their biodegradability, biocompatibility, and safety profile are some of the main features that make these polymers optimal, even in vivo. PLGA is a copolymer consisting of two different monomer units, poly (glycolic acid) (PGA) and poly (lactic acid) (PLA), linked together, and the result is a linear, amorphous aliphatic polyester product. In vivo, the polymer undergoes degradation by hydrolysis with the following formation of the original monomers (i.e., lactic acid and glycolic acid), which are endogenous monomers also produced in normal physiological conditions. Thus, they are easily processed via metabolic pathways such as the Krebs cycle and removed as carbon dioxide and water, causing minimal systemic toxicity. Its success is particularly related to its continued drug release compared to conventional devices and to the negative charge, which is also crucial because it strongly influences the interaction between NPs and cells [
30]. Another synthetic and biocompatible polymer extensively studied is PVA. PVA is frequently used as an emulsifier in the formulation of PLGA-PVA NPs due to its ability to form an interconnected structure with the PLGA, helping to achieve NPs that are relatively uniform and small [
31,
32]. In addition to the above-mentioned reasons, the simple and reproducible synthesis process and the possibility of surface functionalization (i.e., with targeting mechanisms) led us to focus on these nanodevices. Moreover, PLGA-PVA NPs keep water-soluble drugs/compounds trapped in the aqueous inner core, making these NPs an optimal delivery system.
PLGA-PVA NPs are spherical nano-sized core/shell structures that bind B-cells in a dose-dependent manner. When injected into the bloodstream of ZF embryos through the duct of Cuvier, which is an embryonic vein structure collecting all venous blood and leads directly to the heart’s sinus venosus, NPs are broadly distributed in the embryo’s body with a predilection for a region in the tail of the fish, known as the posterior blood island (PBI). This flat area is characterized by a reduced speed of the bloodstream, which facilitates the visualization of circulating NPs. Since the PBI is known to be a macrophage-rich area [
20], the different accumulation of NPs is probably due to the macrophages’ engulfment. To confirm this point, the transgenic ZF line Tg (mpeg1:mCherry) was previously exploited to visualize the interactions between macrophages and other immune cells or pathogens in vivo and to reexamine macrophage roles in inflammation, wound healing, and development, as well as their interactions with other cell types (e.g., vasculature, muscle) in vivo [
33]; more interestingly, they represent a useful model in the study of the interaction between macrophages and NPs injected into the bloodstream. This approach allowed us to clarify that ~20% of PLGA-PVA NPs colocalize with the macrophages, indicating that this population of cells is implicated in their elimination, and this is probably due to the high surface-area-to-volume ratio. Moreover, when administered in vivo, NPs interact with circulating proteins (e.g., albumin, complement proteins, fibrinogen, and immunoglobulins) that are attracted to their surface to form a coating layer called protein corona; this affects the biological identity of NPs and, consequently, their functionality [
34]. As a consequence, NPs became more visible to phagocytic cells, which recognize the materials via ligand–receptor interactions leading to the rapid elimination of NPs. On the other hand, the remaining ~80% of NPs remain free to execute their duty at the moment of the analysis.
In vivo experiments are strongly recommended to verify NPs’ behavior in a complex environment; the optimal way to assess the efficacy of drug-loaded NPs is represented by observation of tumor growth arrest and a reduction in its burden. Therefore, the ZF embryo represents an interesting animal model considering that it embodies a versatile platform for xenotransplantation without risk of rejection. On the other hand, this feature also represents a limitation. Indeed, due to the lack of an adaptative immune system in this developmental stage, which is a difference from other, more complex animal models, such as mice and rats, ZF embryos do not allow us to evaluate the key role of adaptive immunity in the tumor microenvironment and cancer progression [
7].
A diffused model of ALL is obviously a more realistic scenario; however, to better quantify the effect of drug-loaded NPs, a localized one is recommended. Therefore, a localized xenograft model was set up by injecting cells in the perivitelline space (at the margin between the yolk sac and the embryonic cell mass). The model clearly allowed the visualization of tumor cells localized in the ventral thoracic area and the verification of the tumor’s dimensions through the fluorescent signal given by viable cells.
For what concerns the treatment of ALL, anthracyclines are a well-known class of chemotherapeutics that act mainly by intercalating DNA and interfering with DNA metabolism and RNA production. Two major dose-limiting toxicities of anthracyclines include myelosuppression and cardiotoxicity [
26]. The PEGylated liposomal doxorubicin formulation “Doxil” was the first US Food and Drug Administration (FDA)-approved liposome chemotherapeutic agent in 1995. It has shown highly selective tumor localization and excellent pharmacokinetic properties in clinical applications. Starting from this point, anthracyclines were chosen as candidates to be encapsulated inside nano-devices. Among anthracyclines, doxorubicin is widely used; however, its clinical use is restricted due to the severe risk to develop cardiotoxicity [
26]. To specifically address this point, PLGA-PVA NPs loaded with doxorubicin were produced; their in vitro characterization demonstrated that the features of the NPs were not influenced by the presence of the drug in the core and that the cytotoxic activity of the drug was also maintained after its loading into the nano-devices.
The therapeutic efficacy of drug-loaded NPs was easily verified in a localized model of human leukemia in ZF embryos. It was possible to immediately visualize the local distribution of the cells and to measure the tumor burden. The potential therapeutic effect of drug-loaded NPs was obtained in only 24 h. Tumor-bearing ZF embryos were analyzed immediately after the injection of NPs and 24 hpi through fluorescence microscopy. The variation of the fluorescent signal highlights that the tumor burden in ZF that received drug-loaded NPs was reduced by more than 85% in comparison with ZF treated with NPs. Therefore, these data confirm the safety of the polymers in vivo and the therapeutic efficacy of drug-loaded NPs in a localized model of B-cell malignancy.