We have previously constructed triple-helical
α1(IV)1263–1277

PAs, which have been shown to be specific for CD44/CSPG [
41,
47–
49]. In order to develop a targeted nanoDDS specific for metastatic melanoma,
α1(IV)1263–1277

PA has been incorporated the into liposomes [
23,
62]. The results of our prior study indicated that liposomes composed of DSPG, DSPC, and cholesterol (molar ratio 1

:

4

:

5) were the most suitable for
in vitro and
in vivo applications [
23,
63]. These liposomes proved to be the most stable of the systems tested, and the presence of the
α1(IV)1263–1277

PA did not affect the liposomal stability. Results obtained through a series of competitive displacement experiments verified CD44/
α1(IV)1263–1277

PA liposome recognition [
23,
62]. More specifically,
α1(IV)1263–1277

PA liposomal rhodamine delivery correlated with cellular CD44 content and was inhibited in a dose-dependent fashion by exogenous
α1(IV)1263–1277

PA [
23]. Fluorescence microscopy revealed localization of
α1(IV)1263–1277

PA liposomes to CD44-positive cells [
62].
In the present study, we further modified DSPG/DSPC liposomes with the addition of PEG. Such modifications have previously been shown to increase liposome circulation times
in vivo [
53,
76–
82]. We used 5

mol % of PEG-2000 in our liposomes (), the same amount of PEG used in the clinically approved drug Doxil (DOX encapsulated PEG-stabilized liposomes) [
83]. The size of the PEG chain chosen took into account the size of the PEG used in Doxil (PEG-2000) [
83], as well as the impact PEGs of various sizes could have on our system specifically. Previous studies suggested that increased circulation times can be achieved with increasing PEG chain lengths up to PEG-5000 [
77,
84,
85]. However, we chose not to utilize PEG larger than 2000

Da for three reasons. First, it has been shown that rigid liposomes composed of DSPC (as is the case here) exhibit a drop off in circulation times when PEG greater than 2000

Da is incorporated due to chain entanglement and lipid phase separation resulting in increased opsonization [
85–
88]. Second, previous work using membranes containing a mixture of the
α1(IV)1263–1277

PA and PEGs of various sizes resulted in binding of M14#5 human melanoma cells when PEG-120, PEG-750, or PEG-2000 were used, but not with PEG-5000 [
89]. Neutron reflectivity data revealed head group lengths of 8.8, 9.0, and 16.8

nm for
α1(IV)1263–1277

PA, DSPE-PEG-2000, and DSPE-PEG-5000, respectively [
89]. The lack of binding observed with PEG-5000 was thus attributed to the complete masking of the
α1(IV)1263–1277

PA by the PEG, thereby minimizing ligand accessibility. Third, the presence or absence of 5% PEG-2000 in
α1(IV)1263–1277

PA/DMPC (1

:

19) liposomes had little effect on the delivery of Texas Red to CD44-positive fibroblasts [
62].
In the present study, cells were directly exposed to each liposomal system and free DOX and incubated at 37°C. In this environment, free DOX can be taken up by cells more rapidly than liposome encapsulated DOX. However, free DOX was not as efficacious as CD44 targeted liposome encapsulated DOX towards M14#5 melanoma cells (). Thus, the targeting strategy promoted more efficient DOX delivery in vitro. Further supporting this conclusion was the observed correlation between the cytotoxic effect of DOX-loaded targeted liposomes and CD44/CSPG content for M14#5 and BJ cell lines.
Eliaz and Szoka Jr. developed CD44-targeted liposomes using HA fragments (see
Section 1) [
20]. Following a 3

h treatment of B16F10 mouse melanoma cells with DOX encapsulated HA liposomes, IC
50 values of 0.78–3.62
μM were observed [
20]. The IC
50 value for our CD44-targeted liposome is slightly higher (approximately 9-10
μM), but we have examined activity against a highly aggressive human melanoma cell line. In addition, as discussed earlier, using HA as a targeting moiety suffers from reduced selectivity as (a) the cell surface receptor RHAMM binds to HA just as avidly as CD44 [
28,
29] and (b) HA binding to CD44 is not sensitive to distinct glycosylation patterns of this receptor, while
α1(IV)1263–1277

PA binding is [
41]. Eliaz and Szoka Jr. reported an IC
50 value for nontargeted PEG liposomes of >172.4
μM, similar to what we observed for nontargeted PEG liposomes with M14#5 melanoma cells (117.6
μM; ).
Potential DOX delivery
in vivo, however, is quite different than
in vitro when one considers circulation times. Unlike DOX encapsulated within PEGylated liposomes, free DOX is rapidly cleared from circulation, and therefore exposure to tumor cells is limited. In fact, it has previously been reported that free DOX is cleared 450-times faster than DOX encapsulated within PEGylated liposomes [
90,
91]. Furthermore, extravasated PEGylated liposomes experience enhanced retention within the tumor site, which has been attributed to a lack of functional lymphatic drainage in tumors [
51,
92]. In the B16F10 mouse melanoma model, DOX incorporated within nontargeted liposomes showed little effect in reducing tumor size, while targeted liposomes significantly reduced tumor size (). The improved activity was due to the selective uptake of targeted liposomes by CD44-expressing cells rather than DOX released from disintegrated liposomes, as the targeted liposomes were more effective than the nontargeted liposomes (), while both liposome types were of similar stability (Figures –). The liposomal formulation utilized here has been noted previously as being highly stable compared with other liposomal compositions [
63].
Several prior studies have examined the efficacy of DOX encapsulated, targeted liposomes on mouse tumor models [
22,
24,
93]. Most relevant to the present study, Peer and Margalit compared DOX encapsulated HA liposomes, DOX encapsulated liposomes, and saline [
22]. Mice were injected with C-26 colorectal tumor cells and treated at 4, 12, and 19 days with 10

mg/kg DOX. At day 31, tumor sizes were ~100, ~400, and ~1250

mm
3 for the HA liposome, liposome, and saline treatments. Thus, CD44 targeting via HA appeared to be effective. The relative reduction in tumor size by the HA liposomes compared with saline (~12.5-fold) was greater than seen here (~2-fold; ), but the DOX dose in the prior study was twice that of our treatments (10

mg/kg versus 5

mg/kg) and the tumor type was different (colorectal versus melanoma). It should be noted that the B16F10 tumor is highly aggressive, with a doubling time of less than 24

h. Interestingly, the difference in activity for the HA liposomes and liposomes (~4-fold) [
22] was comparable to that observed here for the CD44-targeted and nontargeted liposomes (~3-fold; ).
Goren et al. utilized folate-targeted liposomes for treatment following injection of M109R-HiFR lung tumor cells into mice [
93]. Tumor cells were pretreated with liposomes ([DOX] = 10
μM) and injected. The tumor weights after 35 days were 381

mg for untreated mice, 397

mg for mice treated with PEG liposomes (Doxil), and 57

mg for mice treated with folate-targeted liposomes. The relative reduction in tumor size by the folate-targeted liposomes compared with untreated mice (~6.7-fold) was also greater than that observed here. However, a significant difference between our study and that of Goren et al. is the injection of the tumor cells after pretreatment with liposomes in the latter case. One would anticipate that the liposomes would have a greater effect on tumor growth if they interacted with the tumor cells prior to the initiation of the tumor
in vivo.
An apparent anomalous result from our study was the increased tumor size following nontargeted liposome treatment compared with saline control (). Prior studies have typically reported the opposite result. For example, Charrois and Allen compared DOX encapsulated Stealth (PEG) liposomes with saline control for treatment of 4T1 mouse mammary carcinoma [
70]. Saline or 6

mg/kg DOX encapsulated liposome was administered at day 4. At day 23, the tumor sizes were ~500

mm
3 for the saline treated mice and ~80

mm
3 for the liposome treated mice. In similar fashion, Han et al. compared DOX encapsulated PEG liposomes, DOX encapsulated comb-like polymer-incorporated liposomes, and PBS control for treatment of B16F10 inoculated mice [
94]. Mice were treated at day 6 with 6

mg/kg DOX. At day 13, the tumor sizes were 300

mm
3 for PBS control and 50

mm
3 for the PEG liposomes and comb-like polymer liposomes. It is worth noting that, in our study, the differences between nontargeted liposomes and saline control were small at day 7 (), which is similar to the result of Goren et al. reported above [
93]. Also, the result at day 9 for the saline control is skewed lower due to one mouse treatment in which the tumor size decreased compared to day 7.
The nanoDDS described in the present study possesses several features to enhance drug selectivity and availability. The targeting capabilities rely upon a ligand that is uniquely selective for the CSPG-modified form of CD44 [
41]. Although modeled after a collagen-derived sequence,
α1(IV)1263–1277

PA is not recognized by the collagen-binding integrins found in melanoma (
α1
β1,
α2
β1, and
α3
β1). Thus, promiscuous receptor binding is avoided, unlike the use of HA for targeting CD44. The triple-helical nature of the ligand renders it reasonably stable to proteolysis, especially compared to other targeting molecules. The nanoDDS can also incorporate PEG to improve circulation time while minimally compromising cytotoxic activity. In principle, multitargeting can be achieved by straightforward incorporation of additional PA ligands. Multitargeting may be especially advantageous for imaging and/or therapy of cancer stem cells, where targeting of only one cell surface biomarker may not encompass the full population [
16]. Thus, PA targeted liposomes may represent the “next generation” of liposomal nanoDDSs [
3,
51] that have potential to enhance selectivity and targeting of chemotherapeutic treatments against metastatic melanoma in the human body. Information from these initial
in vivo studies can guide us to improve the design of the targeted delivery vehicles.