Theranostic Niosomes as Promising Tool for the Combined Therapy

Combined Therapy and Diagnosis: 'All in One. 2. Approach'. 3 ... 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 5...
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Theranostic Niosomes as Promising Tool for the Combined Therapy and Diagnosis: ‘All in One Approach’ Bilal Demir, Firat Baris Barlas, Z. Pinar Gumus, Perihan Unak, and Suna Timur ACS Appl. Nano Mater., Just Accepted Manuscript • DOI: 10.1021/acsanm.8b00468 • Publication Date (Web): 01 Jun 2018 Downloaded from http://pubs.acs.org on June 1, 2018

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Theranostic Niosomes as Promising Tool for the

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Combined Therapy and Diagnosis: ‘All in One

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Approach’

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Bilal Demir *,†, F. Baris Barlas †, Z. Pinar Gumus ‡, Perihan Unak §, Suna Timur *,†,‡

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Ege University Faculty of Science Biochemistry Department 35100 Bornova, Izmir/Turkey

Ege University, Central Research Testing and Analysis Laboratory Research and Application

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Center, 35100 Bornova, Izmir/Turkey §

Ege University, Institute of Nuclear Sciences, 35100 Bornova, Izmir/Turkey

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*Corresponding Authors: Prof. Suna Timur ([email protected]) and Dr. Bilal Demir

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([email protected])

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KEYWORDS: Theranostics, niosomes, multimodal nanoparticles, cell imaging, targeted therapy

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ABSTRACT

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Since the great achievement and progress made for the generation of novel nanostructures,

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theranostic nano-platforms have been the trend topic due to their intensive capability of therapy

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and diagnosis. Hence, theranostics have also been a generic strategy for the personalized

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medicine, recently. Moreover, traditional therapy modalities limit the use of chemotherapeutic

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agents for every patient and this requires more effective drug carrier systems by designing the

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formulation of drug in a specified way. Herein, we performed a generic theranostic platform in

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"all-in-one" concept by the combination of two therapy modalities with active targeting

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approach. To achieve this, 10 nm gold nanoparticles (AuNPs) and protoporphyrine IX (PpIX)

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were encapsulated into folic acid (FA) tagged niosome vesicles. Resulted AuNP-PpIX-FA

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niosomes were characterized and their particle size was 93±17 nm with a high surface charge

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and encapsulation efficiency (around 85%). In the case of bio-applications for AuNP-PpIX-FA

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niosomes, folate receptor positive (FR(+)) human cervical cancer cell line (HeLa) and FR

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negative (FR(-)) human alveolar type-II (A549) like cell line were examined with the relative

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control groups of theranostic vesicles. By testing the toxicity of vesicles, non-toxic

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concentrations were introduced to cell with the combined treatment of radiotherapy and

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photodynamic therapy, successfully. On the other hand, cellular uptake of niosomes were also

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showed its great potential for FR (+) HeLa cells as the theranostic platform with all-in-one

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approach.

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INTRODUCTION

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Synthesis of theranostic nano-structured materials such as nanoparticles (NPs) and nanovesicles

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is the promising matter of nanotechnology and gained a great attraction. Besides

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biocompatibility, theranostic nanoplatforms are needed to have various functionalities such as

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imaging, therapy and drug delivery abilities.1,2 Also, these materials can be adapted to targeting

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strategies or designed for passive processes.3

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Drug targeting approaches have been divided into categories as “Passive” and “Active”.

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“Passive targeting” is based on drug accumulation to around the tumors with leaky vasculature;

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which is referred to as the enhanced permeation and retention (EPR) effect. On the other hand,

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“Active targeting” denotes to selective ligand–receptor type interaction after nanomaterials reach

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to the target cells and requires an efficient interaction between the drug carrier and the target

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cells.4

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Niosomes are vesicular drug carriers exhibiting a bilayer structure similar with the liposomes

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and are in most cases formed by self-association of non-ionic surfactants and cholesterol in

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aqueous media. Various therapeutics with a wide range of solubility could be entrapped into the

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aqueous core or in between membrane bilayer of these structures.5,6 Therefore, these nanocarriers

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could act as multifunctional platforms which allow loading various molecules such as imaging

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and therapy agents. The efficiency of niosomal systems can be improved by active targeting

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process by using a proper ligand attached to the surface of niosomes. Recently, polyethylene

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glycolated niosomes were used to encapsulate both doxorubicin and curcumin and then,

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successfully targeted to glioblastoma cells by using tumor homing and penetrating peptide.7 In

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the other study, encapsulation of gadolinium nanoparticles and protoporphyrin IX (PpIX) into

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niosomes were carried out and these structures were applied to cancer cells via passive targeting

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process.8

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encapsulate gold nanoparticles (AuNP) and PpIX together. These nanovesicles could be

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promising candidates for photodynamic therapy (PDT) and radiotherapy (RT) as well as

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combined therapy (PDT+RT) and cell imaging applications. All through the experiments, FR

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targeted nanocarriers were applied to FR positive and negative cell lines (HeLa and A549 cells)

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as the model cancer cells, by means of active targeting. After characterization steps, efficiency of

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targeted niosomes were tested as imaging (fluorescence) and RT, PDT and combined therapy

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(RT plus PDT) systems.

Herein, we described folate receptor (FR) targeted niosomes which are used to

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PDT has emerged as a promising alternative for the treatment of malignant diseases. PDT

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involves the administration of photosensitizers (PSs) followed by illumination of the tumor with

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a localized energy source to activate the specific PS. Due to the presence of those components,

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cells are exposed to reactive oxygen species (ROS) such as singlet oxygens, which are generated

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by the excitation of PSs to T1 state from a ground state with light. Numerous clinical trials of

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PDT have been conducted and PDT is used with increasing frequency in a variety of cancers,

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such as skin, lung, and cervix.9 Recently, PSs used in clinical purposes are mainly originated

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from porphyrins, chlorophylls, and dyes.10 Porphyrins are extensively applied for clinical uses;

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for instance, ‘Photofrin’ has been approved by FDA. It also has a good potential for

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radiosensitivity under ionizing irradiation by increasing energy uptake in cancer cells in

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comparison with healthy cells. On the other hand, RT has traditionally been one of the most

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common and efficient treatments of cancer and other diseases with ionizing radiation. RT causes

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lethal damage to disease cells by damaging the cellular DNA. Undifferentiated tumor cells are

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considered more susceptible to RT as they have a diminished ability to repair sub-lethal DNA

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damage.9,11

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In addition to the use of NPs in nanomedicine,12-15 promising demonstrations of the

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radiosensitizing potential of NPs in the last decade, both in vitro and in vivo, now mean that

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significant research efforts focus on NPs for improved dose localization for radiotherapy.

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Besides, novel sensitizers, such as NPs, have shown to locally increase the damaging effect of

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both photon and ion radiation, when both are applied to the tumor area. As NP systems, AuNP

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have become particularly popular due to several advantages such as biocompatibility, well-

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controlled methods for synthesis in a wide range of sizes, and the possibility of functionalization

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of their surface with various molecules to provide partial control of, for example, surface charge

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or interaction with serum proteins.16

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By creating an "all-in-one" approach, we engineered a novel theranostic platform with niosome

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vesicles as the main nanocarrier materials. RT effect of AuNPs and PDT effect of

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protoporphyrine IX (PpIX) under proper irradiation conditions were utilized after their

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encapsulation into folic acid tagged niosome vesicles. The following characterization related to

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physcochemical parameters such as size and surface charge and morphology, bio-investigations

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of the final AuNP-PpIX-FA theranostically engineered particles were examined with the folate

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receptor positive (FR(+)) human cervical cancer cell line (HeLa) and FR negative (FR(-)) human

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alveolar type-II (A549) like cell line. Within RT and PDT, combinatorial therapy modality

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studies and cellular uptake of AuNP-PpIX-FA vesicles were tested in the comparison of their

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relative control groups, accordingly.

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2. EXPERIMENTAL SECTION

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Materials. Tween 80, folic acid (FA), 1,1'-Carbonyldiimidazole (CDI), cholesterol (Chol),

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protoporhyrin IX (PpIX), dimethylsulfoxide (DMSO), chloroform, methanol, sodium dodecyl

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sulfate (SDS) and 3-(4,5-dimethylthiazolyl-2)- 2,5-diphenyltetrazolium bromide (MTT) and 4',6-

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diamino-2-phenylindol (DAPI) were purchased from Sigma Aldrich (St. Louis, USA). 10 nm

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citrate-stabilized gold nanoparticles (AuNPs) were purchased from BBI Solutions (Cardiff, UK).

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Penicillin/streptomycin (10 000 UI/mL), Dulbecco's Modified Eagle's Medium (DMEM), L-

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glutamine (200 mM), phosphate buffered saline (PBS) and trypsin/ethylenediaminetetraacetic

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acid (EDTA) (0.05% trypsin in 0.2 g/L EDTA) and phoshate buffer saline (PBS) used in cell

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culture experiments were purchased from Lonza (Basel, Switzerland). Fetal bovine serum (FBS)

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was purchased from Biowest (Nuaillé, France). Phosphate buffer saline (PBS) was prepared with

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8.0 g/L NaCl, 0.2 g/L KCl, 1.44 g/L Na2HPO4 and 0.24 g/L KH2PO4 at pH 7.4 for synthesis and

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characterization studies. Water was purified using a Milli-Q system (Millipore, Molsheim,

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France).

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Synthesis of Tween 80-FA conjugate. Prior to the preparation of niosomes, Tween 80-FA

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conjugate was synthesized according to a previous protocol by Chen et al.17 Briefly, 1.66 g

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Tween 80 and 0.66 g CDI were dissolved in 5.0 mL DMSO and incubated for 2 h at 40 oC with

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stirring. Diethylether was added onto the Tween 80:CDI mixture thoroughly to separate the

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excess CDI from the activated Tween 80. After separation by using the funnel, activated Tween

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80 was kept in oven (55 oC) for 2 h to concentrate the intermediate. Tween 80 which has

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activated -OH groups was introduced into 30 mL Na-Carbonate buffer (10 mM, pH 9.0)

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containing 0.36 g FA for 4 h at room temperature under shaking. Following the reaction, dialysis

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(MW: 1000 Da) was applied to purify the final Tween 80-FA conjugate. In the final step, water

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soluble conjugate was lyophilized for 3 days with a benchtop freeze dryer (Labconco, Missouri,

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USA) and kept at 4 oC for the further characterization and use in preparation of theranostic

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niosomes. The synthesis of the conjugate is demonstrated in Scheme 1.

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Scheme 1. Synthesis of Tween 80-FA conjugate with carbonyldiimidazole (CDI) activation of -

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OH groups.

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Preparation of theranostic niosomes. Theranostically designed niosome formulations were

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prepared via traditional thin film hydration method followed by a sonication step. Initially, 0.1

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mM Tween 80: Chol (1:1 molar ratio) were dissolved in chloroform: methanol (3:1 v/v) mixture

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in a 50 mL round-bottom flask for the further rotary evaporation to obtain a surfactant film by a

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Buchi-RII Rotavapor model evaporator (BUCHI Labortechnik AG, Flawil, Switzerland)

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equipped with a vacuum pump. Surfactant/Chol film was hydrated with 10 mL PBS (pH 7.4)

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which contains 500 µL, 10 nm AuNP solution (taken directly from commercial stock) and 100

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µM PPIX. The addition of Tween 80-FA conjugate solution (which was dissolved in DMSO:

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PBS (1:9) for 0.0387 mg/mL as the final concentration in niosome solution) into niosome

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bilayers was applied via insertion during hydration process. Following the 2 h of incubation at 50

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o

C, latter vigorous vortexing was applied until the complete detaching of film layer from the

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flask surface. In order to get small unilamellar vesicle distribution, niosome suspension was

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sonicated for 30 min at room temperature. In the final step, the sonicated AuNP-PpIX-FA

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niosomes were dialyzed against distilled water overnight by a dialysis membrane (MW: 12000 –

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14 000 Da).

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To create control groups for cellular bio-applications which can demonstrate the strategic

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differences, AuNP-PpIX and PpIX-FA containing niosomes were prepared for the comparison,

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separately. The constructed niosomal samples were stored at +4 oC by protecting from light.

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Characterization. To illuminate the conjugation of Tween80-FA after lyophilization, Fourier

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transform infrared (FTIR) spectra of Tween 80-FA was obtained by using a Pyris 1 FTIR

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Spectrometer (Perkin–Elmer Instruments, Massachusettes, USA) on KBr plates. Moreover, high

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performance liquid chromatography (HPLC) was applied to the sample to verify the conjugation

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efficiency of FA to CDI activated Tween80. The chromatographic analysis of FA was conducted

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by using HPLC (Agilent) with DAD detector (Santa Clara, CA, USA) and the elution of the

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peaks in the chromatogram was performed with an Eclipse XDB-C18 column (5.0 µm particle

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size, 4.6x150 mm). For the FA analysis, the following procedure was applied. The mobile phase

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consisted of a mixture of (A) 1.0 % (v/v) aqueous phosphoric acid and (B) acetonitrile (90:10,

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v/v). Flow rate was adjusted to 1.2 mL/min and the detector wavelength was set at 283 nm. The

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injection volume was 20 µL and the column temperature was maintained at 25 °C. The stock

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solutions of FA (10-500 ppb) were prepared in methanol and conjugation efficiency of Tween80-

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FA was determined via the obtained calibration curve from HPLC with the equation of y =

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0.032x + 0.083 (R2 = 0.999). Limit of detection and limit of quantitation values are 1.58 ng/mL

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and 5.28 ng/mL, respectively. Similar conditions were also carried out to exhibit the Tween80-

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FA insertion efficiency into niosomes.

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After the synthesis of theranostically designed AuNP-PpIX-FA and control formulations, initial

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step for the first characterization related to those theranostic vesicles was to determine the

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hydrodynamic particle size distributions and surface charges. Prior to the measurements of

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surface and hydrodynamic characteristics, each niosome sample was diluted as 20 times in water.

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The measurements were carried out as via a Zetasizer Nano ZS (Malvern Instruments Ltd., U.K.)

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at a scattering angle of 90o using a wavelength of 633 nm and at room temperature. Zeta

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potential analysis was performed by the same device according to Smoluchowski equation.

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Surface charge and size measurements were repeated as three times with the samples prepared in

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different days.

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Encapsulation efficiency (EE) of developed niosomes was also calculated by using PpIX as the

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model photosensitizer in this work. For that, freshly dialyzed niosome stocks were used. The

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decomposition of vesicle bilayer was performed by vortexing and sonication for 10 min in

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methanol. The prepared standard solutions of PpIX in PBS with varying concentrations between

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1.0-200 µM were used for the calibration curve of PpIX. Afterwards, decomposed PpIX

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niosomes were diluted with PBS and EE% of each niosome formulation was calculated

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according the following equation:

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Entrapment efficiency (EE%) = (Encapsulated PpIX Amount/Initial PpIX Amount) x 100

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Inductively coupled plasma mass spectrometer (ICP-MS; 7500ce octopole reaction system,

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Agilent, California, USA) experimentation was carried out to detect total Au concentration after

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the decomposition of niosomes as well. The linear calibration curve for Au concentration is

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between 0-1000 ppm.

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To investigate the morphological structures of developed surfactant vesicles, atomic force

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microscopy (AFM) was introduced. Prior to the sample deposition over indium tin oxide (ITO)

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glasses, a cleaning procedure was performed with sonication successively for 15 min, in

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detergent solution, de-ionized water, acetone and 2-propanol, sequentially. The measurements

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were carried out under ambient conditions by using an NT-MDT NTEGRA SOLARIS. To obtain

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the topographic images, the non-contact mode (tapping mode) was selected. A 10 mm scanner

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equipped with silicon tips with 10 nm tip curvature was used for measurements. After drying in

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nitrogen stream, niosome solutions (diluted as 10 times in water) were immediately spin coated

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on the ITO substrates at 20 oC and then directly measured via AFM.

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Transmission electron microscopy (TEM) was performed to visualize the AuNPs inside vesicles.

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Firstly, main stock of AuNP-PpIX-FA sample was diluted 50 times (20 µL sample + 1980 µL

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water) and dispersed for 5 min in a bath sonicator. 20 µL of this dilution was covered onto grid

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and after drying process, images were captured by a JEM-2100F (JEOL, Japan).

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Cellular Investigation of Theranostic Niosomes

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Human cervical cancer cell line (HeLa) and human alveolar type-II (ATII)-like cell line (A549)

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were sub-cultured in DMEM supplemented with 10% (v/v) FBS, 2.0 mM glutamine, 100 µg/mL

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penicillin/streptomycin, in 75 cm2 flasks at 37 °C, 5.0% CO2 and 100% humidity, until reaching

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80% confluency. 0.25% (w/v) trypsin/EDTA in PBS was used for the cell passage as two times

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per week to maintain the cultivation during cell culture studies.

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Cell viability. A conventional MTT set up was established to investigate the cell viability

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responses of developed vesicles in a dose-dependent way by using the standard protocol in our

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previous studies.18,19 In brief, 8.0x103 cells were inoculated into 96 well-plate and incubated for

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48 h in standard cell culture conditions. Subsequently, the culture medium was replaced with the

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treatment medium including different concentrations of PpIX containing niosomes for 24 h

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incubation. In the end of incubation with samples, cells were treated with 110 µL/ well MTT

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solution (10%, 5.0 mg/mL in sterilized PBS, pH 7.4) in medium for 4 h. Following the MTT

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treatment, 100 µL SDS (1.0 g SDS in 10 mL of 0.01 M HCl) was then added to the wells to

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dissolve the purple-colored formazan crystals which were produced in cells. In the final step of

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24 h incubation, the optical densities of each well were analyzed with a spectrophotometric plate

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reader (Bio-Tek Instruments, Inc., Winooski, VT, USA) at 570 nm and 630 nm as well. As

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designed in characterization part, same control samples including AuNP-PpIX and PpIX-FA

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niosomes were applied to the cells for the comparison.

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Radiotherapy (RT). To exhibit the possible therapeutic efficiency of AuNP-PpIX-FA niosomes,

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samples were treated with cells under irradiation. For that, we carried out an established protocol

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from our previous study related to AuNP conjugates for cancer therapy.20 Briefly, 4.0x103 cells

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were seeded to 96-well plates and incubated overnight. Then, medium was replaced with the

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maximum nontoxic concentrations of samples after 3 times washing with PBS. Afterwards, cells

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were irradiated for 2 h with 2.5 Gray (Gy) of radiation which was delivered by a 6 MV linear

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accelerator system (LINAC, Siemens Primus, Germany). As the next step, cells were incubated

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for 72 h in ideal cell culture conditions (37 oC, 5.0% CO2 with 100 % humidity) and the standard

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MTT assay was conducted to observe the cytotoxic effect as described in Cell Viability part.

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Photodynamic therapy (PDT). In PDT experiment, a previous protocol by Morimoto and co-

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workers was carried out with a small re-modification.21 Briefly, 1.5x104 cells were seeded in 24-

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well plates and cultivated for 48 under ideal cell culture conditions. Afterwards, HeLa and A549

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cells were pre-treated with the AuNP-PpIX-FA, AuNP-PpIX and PpIX-FA samples, accordingly.

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Following 2 h, a homemade LED lamp (5.1 J/cm2) was used to deliver light for 5 min exposure

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between 400 and 700 nm wavelength ranges. Cell viability was measured by MTT method after

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24 h incubation at the ideal conditions as described above.

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Combined therapy assay. This novel assay which was early optimized in our lab was carried

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out to investigate the combined therapy effect of PDT (5 min light with 5.1 J/cm2) and RT (2.5

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Gy) on the cell viability.8 Within this combination, a similar treatment procedure was also

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conducted for AuNP-PpIX-FA and the control groups at their maximum nontoxic concentrations.

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In short, PDT for 5 min with 5.1 J/cm2 and a subsequent 2 h irradiation with 2.5 Gy by LINAC

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system were applied to cells and after 72 h cell viabilities were detected by MTT method as well.

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Cell imaging. In order to monitor the intralocalizations of FR targeted AuNP-PpIX-FA

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theranostic vesicles and also control groups HeLa and A549 cells, 100 µL of maximum nontoxic

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concentration of samples were introduced into the cells grown in a chamber slide for 2 h after 2

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day-cultivation under ideal cell culture conditions. Following the treatment for 2 h at 37 °C in

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CO2 incubator, the cells were washed twice with PBS. The cell images were taken by a

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fluorescence microscope (Olympus BX53F) equipped with a CCD camera (Olympus DP72).

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Cell images were overlapped with the red fluorescence from PpIX and blue fluorescence form

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DAPI in order to monitor nucleus via Image J software.

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Statistical analysis. All the experiments placed in this study were repeated at least 3 times and

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data were expressed as average ±SD (standard deviation) unless particularly outlined. A one-way

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analysis of variance (ANOVA) was conducted with a post-test of Tukey's multiple comparison

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test for the statistical evaluation. The difference between two groups was considered to be

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significant when the ‘P’ value was less than 0.05 and highly significant when the ‘P’ value was

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less than 0.01 or 0.001.

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3. RESULTS AND DISCUSSION

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The increasing trend to find novel and more effective therapeutic approaches in the war of cancer

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revealed many opportunities resulting in required multidisciplinary way. To keep up with this

6

trend, researchers have been studied on multifunctional nanocarriers which enable multimodal

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therapy and diagnosis as well or their combinations. In this work, we mainly focused on the

8

design and bio-application of a novel FR targeted niosomal formulation. To create a more

9

effective platform in one carrier, theranostic engineering was conducted to niosome vesicles by

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including PpIX and AuNPs to the structures as PDT agent and RT agent, respectively.

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Concomitantly, niosomes as the surfactant vesicles have gained great attraction as a nanocarrier

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platform thanks to their advantageous properties over lipid-based vesicles. Although it is known

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that liposomes are more easy-to-modify and open for post-functionalization to create specificity,

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these vesicles are more fragile due to rapid oxidation under atmosphere and light for long

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durations. In order to overcome these drawbacks, niosomes were prepared as FR targeted with

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the addition of FA conjugated Tween80.

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Synthesis of Tween 80-FA conjugate. Prior to the preparation of niosomes, FA conjugation was

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enabled to Tween80 thanks to its structure bearing pendant -OH groups via CDI coupling. After

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the activation of each -OH group at Tween80, -NH2 group of each FA was successfully

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conjugated and purified as mentioned in experimental part. In order to analyze the conjugation

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efficiency, HPLC analysis was accomplished with the standard curve and equation for FA in ppb

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level accuracy. During the synthesis, 0.36 g, FA in 30 mL Na-carbonate buffer was used for

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conjugation (12000 ppm FA as the initial concentration). After purification, it was found that 237

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ppm FA couldn't bind to Tween 80. Therefore, 98% of FA could bind to Tween80, successfully.

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Within that result we can admit that (2-3) FA molecules might be linked to each Tween80

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molecule. Moreover, this high conjugation efficiency was supported by FTIR analysis as well.

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As illustrated in Figure 1, Tween80-FA was compared with plain Tween80 and FA to observe

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the structural changes via specific peaks which have exhibited in FTIR spectra.

6 7

Figure 1. FTIR spectra of Tween80, FA and Tween80-FA conjugate.

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FA is formed from a pteridine ring, p-amino benzoic acid and glutamic acid. In the FTIR

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spectrum of free FA, the most common characteristic peaks at 1610 and 1700 cm-1 were

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generally attributed to -COOH, C=O and aromatic C=C residues on pteridine and phenyl rings,

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vividly.22 There are some characteristic absorption bands which could confirm the presence of

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Tween80 in the conjugation. The bands centered at 2932 and 2873 cm-1 are associated with the

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asymmetric (vas) and symmetric (vs) stretching vibrations of methylene (-CH2), respectively.23

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The band at 1730 cm-1 originates from the C=O stretching of the ester group. The strong band

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between 3400-3500 cm-1 can be attributed to the O-H stretching vibrations as the most common

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peak for primary alcohol groups. In the spectrum of Tween80-FA conjugation, the characteristic

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peaks from both structures can be clearly observed due to the similar peak absorptions around

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3450 cm-1 for FA and 3448 cm-1 for conjugate which are related to N-H stretching beside the

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presence of -CH2 in conjugate. Moreover, the peak absorption which also presents the

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conjugation efficiency might be attributed to C-N (amide bond). As a result, it is clearly

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demonstrated that the first step to construct the FR targeted theranostic platforms was

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successfully completed for the rest of the study.

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Design of theranostic niosomes and characterization. In the concept of theranostic particles,

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niosomes which carry both PpIX and AuNPs were synthesized with the FA tagging over the

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surface of bilayer nonionic surfactant membrane. Following the synthesis, hydrodynamic particle

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sizes of those multifunctional carriers were estimated via DLS method. The final theranostic

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vesicle which contains both PpIX and AuNPs with the FA tagging presents a size of 93±17 nm

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as show in Table 1. Likewise, control vesicles which prepared for the further bio-investigations

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enabled similar particle sizes after sonication to reduce particle size and to achieve unilamellar

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vesicle formation. Besides, AuNPs were also measured within other samples and their size was

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verified as 8.0±2.0 nm as enabled in the manufacturer's instructions.

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polydispersity index (PDI) illustrates the homogeneity of particles in measurement solution.

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According to the obtained results, final theranostic particles AuNP-PpIX-FA have the smaller

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PDI value among three niosome formulations. In the case of zeta potential of developed

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niosomes, all of the formulations demonstrated similar characteristics as -46 and -50 mV which

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indicates all the formulations are stabile.

Concomitantly,

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Table 1. Psychochemical characteristics of developed niosome vesicles. Particle size PDI±S.D. (nm) ±S.D.a

a

Zeta

potential

(mV) ±S.D.a

Encapsulation Efficiency

PpIX (%)±S.D.a

AuNP

8±2

0.14±0.01

-42±7

AuNP-PpIX

69±10

0.64±0.02

-48.5±8

84.16±1.08

PpIX-FA

70±13

0.54±0.1

-46±8

86.31±0.96

AuNP-PpIX-FA

93±17

0.41±0.04

-50±9

86.57±4.26

a

of

±SD values obtained from free-independent measurements of freshly prepared samples.

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Moreover, those three nanovesicles were also tested for their 30 days short-term stability via

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particle size monitoring. After 30 days, the particles sizes of niosomes were found as 71 nm for

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AuNP-PpIX, 77 nm for PpIX-FA and 89 nm for AuNP-PpIX-FA nanovesicles, respectively.

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This data is also in accordance with the high negative surface charges which prove the high

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stability for one month duration.

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As the next step for the characterization, encapsulation efficiencies (EE) of PpIX and AuNP

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particles into niosome vesicles were investigated. EE% of PpIX was determined by

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spectrophotometric method resulting a standard curve with linearity between 1.0- 200 µM PpIX

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in PBS. To calculate the EE%, the equation of y = 0.028x + 0.102 (R² = 0.997) was used. Three

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formulations which contain PpIX have ̴ 85% PpIX amount inside the total niosomes for each

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formulation (Table 1). This obtained result shows the efficiency of the formulation with

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Tween80 and Chol, vividly by giving a high-rate encapsulation for drug molecules like PpIX. On

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the other hand, the presence of AuNPs was investigated for the formulations of AuNP-PpIX and

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AuNP-PpIX-FA. In order to estimate the total Au concentration, ICP-MS system was used and

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results were expressed as mg/L. According to that, 8.1 mg/L (36% encapsulation) for AuNP-

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PpIX-FA and 25.3 mg/L (87% encapsulation) for AuNP-PpIX were found. The dramatic

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difference for the Au concentration inside the vesicles might reveal from the fact that AuNP-

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PpIX vesicles have more polydispersity than final theranostic particles, thus bigger particles

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could contain more AuNPs. In addition, the FA presence in the bilayer membrane might create

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an electrostatic repulsion between free -COOH groups of FA and citrate coated AuNPs by

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resulting less AuNP entrance to the vesicles.

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Within the successful EE of both PpIX and AuNPs, another important parameter for the FA

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tagged vesicles is the insertion efficiency of Tween 80-FA conjugates. This was also calculated

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by HPLC method and insertion efficiencies were found as 97.54% for PpIX-FA and 98.27% for

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AuNP-PpIX-FA vesicles which strongly supports our theory of lesser AuNP amount in AuNP-

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PpIX-FA vesicles.

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Following the physicochemical and encapsulation characteristics, AFM technique was applied in

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order to monitor the morphology of niosome vesicles by spin-coating the samples on a ITO glass

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slide. Figure 2 demonstrates the morphology of three vesicle formulations as well as their

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dispersity over ITO slide by height images. The comparison of three images reveals the spherical

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shapes of each vesicle sample, accordingly. In addition to AFM, transmission electron

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microscopy (TEM) was used to monitor the vesicle structure and presence of AuNPs. Figure S1

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illustrates the one vesicle of AuNP-PpIX-FA sample with a particle size of 88 nm which is very

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close to the DLS result. Moreover, the black intensity inside the vesicles is the proof of AuNPs

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as the normal visualization of heavy metals under TEM.

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Figure 2. AFM histograms (2.5x2.5) of (A) AuNP-PpIX, (B) PpIX-FA and (C) AuNP-PpIX-FA

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vesicles.

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Cell Culture Studies

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Cell viability. Cytotoxicity of theranostic vesicles on FR(+) HeLa and FR(-) A549 cell lines was

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evaluated via conventional MTT assay. For the comparison, the cytotoxicity of AuNP-PpIX and

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PpIX-FA was also evaluated. Cells were exposed to a wide concentration range of test samples

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for 24 h. The obtained MTT data in Figure 3 clearly indicates that cellular viabilities for both

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HeLa and A549 cells decreased after 5.0 µM PpIX bearing niosome vesicles to 60% viability

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levels. Within the comparison of control groups and AuNP-PpIX-FA vesicles, encapsulated

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PpIX created an effect upon both cell lines while it has similar effect on some cancer types. In a

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reported study, free PpIX treatment upon HeLa cells without light irradiation showed its efficacy

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after 9.0 µM whereas synthesized AuNPs (7.0 nm) also revealed a slight decrease in viability

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until 80% compared to control.24 In the case of our findings from MTT assay without any

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treatment, quasi results were obtained after encapsulation of them, while PpIX-FA have not been

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effective at its last concentration. The reason which handicaps this might not be only from

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AuNPs and it might be occurred due to the niosomes' main material, Tween80. According to

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another study with Tween80 niosomes, it was indicated that Tween80 could create toxicity after

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19 µM whereas maximum Tween80 amount for the highest concentration in our results is 58

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µM.25 Hence, the initial reduction point (10 µM PpIX) of cellular viability which contain also ̴15

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µM Tween80 is in accordance with the previous study. Likewise, the effect of carrier material

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presents similar reductions for the final theranostic vesicle formulation. Another important issue

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is that cell viability of A549 cells seems more decreased according to HeLa cells in Figure 3C

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after the treatment of AuNP-PpIX-FA. Concomitantly, statistical analysis also showed that there

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is a significance for the last two concentrations (25 and 50 µM PpIX containing niosomes). On

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the other hand, the difference between AuNP-PpIX and AuNP-PpIX-FA analyzed via one-way

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ANOVA method and there were no significant difference between those groups. As

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aforementioned, it might be due to the Tween 80 and also the possible accumulation of high

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concentrated samples over cells for 2D cell culture platforms which can generate stress

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conditions for cells. Notably, in the general aim of the study was to investigate the combined

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therapeutically effect of those formulations by using their non-toxic levels without any light

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treatment or irradiation. Therefore, 5.0 µM PpIX containing AuNP-PpIX-FA vesicle

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concentration were introduced to the cells with its control samples for the rest of the study.

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Figure 3. Dose-dependent toxicity of (A) AuNP-PpIX, (B) PpIX-FA and (C) AuNP-PpIX-FA

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vesicles for HeLa and A549 cells. X axis means the concentration of PpIX inside vesicles. Error

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bars mean ± standard deviation (n=4).

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Combined therapy of developed niosomes. The challenges during treatment of patients may

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occur with only chemotherapy or combined modalities with different drugs in variable doses.

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The advancing understanding of cancer biology has led us to the development of molecularly

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targeted anticancer drugs. In the final step of our work, theranostically designed AuNP-PpIX-

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FA vesicles was introduced to the FR(+) HeLa and FR(-) A549 cell lines to generate a novel

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candidate in the war of cancer specifically. Since higher amounts of drugs/formulations may

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reveal extra side-effects, it is preferable to combine different modalities with the strategy of

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"all-in-one" concept. Figure 4 illustrates this "all-in-one" approach by using PDT and RT

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together thanks to the unique properties of encapsulant materials in niosome vesicles. After

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every sample with 5.0 µM PpIX checked without any treatment for both cell lines to keep cell

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viability as 100%, therapy modalities were conducted to cell in the presence of theranostically

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engineered AuNP-PpIX-FA and control vesicles, accordingly. For that, we used the 2.5 Gy

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irradiation with 5 min light photo-irradiation as the RT and PDT treatments as optimized in our

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previous paper.8 As expected from RT results, the presence of both AuNPs and PpIX illustrates

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encapsulant materials' RT activities by decreasing the viability under 50%, while control group

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without any samples remains their high viability around 75%. Concomitantly, the another

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important issue is AuNP-PpIX and AuNP-PpIX-FA do not contain same AuNP amount,

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however, it seems FA tagging might enable an important difference by active targeting for

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FR(+) HeLa cells in the comparison of cellular viabilities (p