title: Liposomal doxorubicin: the good, the bad and the not-so-ugly.
abstract: There are direct and indirect indications that PEGylated liposomal doxorubicin (Doxil), a widely used anticancer nanomedicine, has a subclinical immune suppressive effect. As an example of a seemingly bad pharmacological property turning out to be "not-so-ugly", but actually beneficial, the authors highlight the potential benefits of Doxil's immune suppressive effect. These include (1) the decreased uptake of the drug by the MPS which may entail enhanced tumor uptake, and, hence, improved therapeutic efficacy; (2) the use of slow infusion protocols in reducing the risk of hypersensitivity (infusion) reactions; and (3), possible protection against hypersensitivity reactions to co-administered reactogenic drugs. To consider immune suppression as useful represents a paradigm shifts in nanotoxicology and anticancer chemotherapy.
authors.affiliation: a Nanomedicine Research and Education Center , Department of Pathophysiology, Semmelweis University , Budapest , Hungary.|b Department of Nanobiotechnology , Miskolc University , Miskolc , Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Szebeni
authors.affiliation: a Nanomedicine Research and Education Center , Department of Pathophysiology, Semmelweis University , Budapest , Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Fülöp
authors.affiliation: a Nanomedicine Research and Education Center , Department of Pathophysiology, Semmelweis University , Budapest , Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Dézsi
authors.affiliation: c Department of Targeted Therapeutics , MIRA Institute, University of Twente , The Netherlands.|d Enceladus Pharmaceuticals B.V. , Amsterdam , The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Metselaar
authors.affiliation: c Department of Targeted Therapeutics , MIRA Institute, University of Twente , The Netherlands.|e Department of Pharmaceutics , Utrecht Institute for Pharmaceutical Sciences, Utrecht University , The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Storm
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000737:chemistry / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology; D006801:Humans; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology
chemical_list: D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin
keywords: Allergic reactions; anaphylaxis; complement; drug delivery; hypersensitivity; liposomes; phospholipids