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A new drug delivery system that utilizes nanotechnology has been created at UVA Health to help reduce the need for multiple surgeries, showing remarkable, long-lasting benefits in laboratory experiments — indicating its promising potential for real patient care.
This innovative method allows surgeons to apply a paste made from nanoparticles combined with hydrogel to transplanted veins, effectively preventing the formation of dangerous blockages. Such blockages often require heart and dialysis patients to undergo numerous surgeries; dialysis patients, in particular, can require extensive and repeated procedures on their arms, legs, or even around the collarbone to continue their essential treatment.
While UVA’s product, known as “Pericelle,” showed positive results in preliminary tests, there were uncertainties regarding the duration of these benefits. Would this simple and quick application made during the initial surgery continue to protect patients for months? The researchers were hopeful but were taken aback by the most recent findings: Pericelle did not only remain effective at three months after the treatment—when the drug supply ran out—but it was also effective at six months, and continued to show results at nine months.
The research team is still trying to understand the reasons behind these long-lasting effects, but they are thrilled about the implications for their innovation.
“This is significant as it suggests that this treatment could last much longer than we initially anticipated, exceeding typical expectations,” stated researcher Lian-Wang Guo, PhD, who collaborates with UVA’s K. Craig Kent, MD, on this project. “It is incredibly exciting that a single treatment can prevent harmful blockages for several months.”
A $5 Billion Healthcare Drain
Kent, who is a vascular surgeon and leads UVA Health, is very familiar with the issues surrounding “revascularization” procedures. These are performed to restore vital blood flow in patients with cardiovascular diseases; for instance, a leg vein might be relocated to the heart for patients suffering heart failure.
Such procedures are also crucial for creating vascular access for dialysis patients. In many cases, veins and arteries in the arm are surgically connected, allowing blood to be removed, cleaned, and then returned to the body. These vascular connection points, known as “arteriovenous fistulas” or AVFs, cost the U.S. healthcare system around $5 billion annually to manage for patients with end-stage renal disease.
A major issue is that these revascularization surgeries often lead to the very problem they seek to solve: insufficient blood flow. The surgeries can cause a build-up of cells in blood vessels that restricts blood flow.
“The need for repeated surgeries for vascular access and revascularization creates not only a substantial burden for patients but also highlights a critical, unmet need in the medical field,” said Kent, who serves as the chief executive officer of UVA Health and as executive vice president for health affairs at UVA. “The impact on both patients’ lives and the healthcare system is enormous, which is why solutions like Pericelle present a chance to alter this dynamic. We urgently need alternatives that deliver lasting results.”
Kent, Guo, and their partner Shaoqin Gong, PhD, from the University of Wisconsin-Madison, envision that Pericelle could potentially provide a solution. By applying the hydrogel paste to blood vessels, they aim to deliver the drug rapamycin, which can inhibit the growth of invasive cells.
The UVA researchers were initially hopeful that their findings would show that the drug’s benefits would extend beyond the expected three months after application. They anticipated six months would be impressive, but were astonished to observe its ongoing effects in test subjects after nine months.
Although much more research is needed before this treatment can be made available to patients, the team remains optimistic about this recent breakthrough and is excited about future developments. This cutting-edge nanotechnology research will be a critical component of the Paul and Diane Manning Institute of Biotechnology, which is currently being built at Fontaine Research Park in Charlottesville.
“If we can devise a method to eliminate the need for repeated surgeries, it could significantly improve patients’ quality of life,” noted Guo, who is part of the Department of Surgery and the Robert M. Berne Cardiovascular Research Center at the School of Medicine.
Alongside their work on Pericelle, Guo and Kent are also exploring another innovative method called “epiNanopaint,” which would allow surgeons to “paint” nanoparticles onto veins to help prevent future blockages.
This research has received support from the National Institutes of Health’s Center for Accelerated Innovations at Cleveland Clinic (award 1UH54HL119810-06), The Ohio State University Accelerator (award ECG20170069), and funding from the Ohio Development Services Agency (award GRT00051721).
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