To test the hypothesis that gold nanoparticles (GNPs) can improve the sensitivity of human glioma tumors, to radiotherapy (RT) and chemotherapy. Major objectives were to isolate and culture the human glioma tumor cells in vitro, to evaluate the chemo- & radiosensitizing effects of the GNPs, and to extrapolate this sensitization effect to the isocitrate dehydrogenase (IDH) mutation status of the tumor. Fresh post-operative glioma tumor samples were obtained (n = 43) and cultured in-vitro. Morphology of the cultured cells was evaluated using Giemsa staining and the proliferation index was calculated based on their population doubling time (PDT). Western blot assay was performed to evaluate the expression of apoptotic proteins, viz. Bad, Bax, Caspase-3 and Bcl2, involved in the tumor cell death. Each of such cultured patient samples were then divided into 8 therapeutic interventional groups, i.e. control, GNP alone, Temozolomide (TMZ) alone, TMZ+GNP, RT alone, RT+GNP, RT+TMZ, RT+TMZ+GNP groups. Based on this group assignment, the cultured cells were exposed to the following interventions: carboxylic acid functionalized GNPs of diameter 30 nm at a concentration of 100ng/mL, 6MV energy X-rays to an absorbed dose of 10 Grays (Gy) using Varian linear accelerator and/or to the drug TMZ at the concentration of 500nM. Cell viability and surviving fraction of cells (SF) were assessed 24 hours after the interventions using MTT assay & optical density (OD) value comparisons with the control group (mean SF 100). Study results showed that 36 patients’ samples, cultured successfully in vitro, were evaluable. The RT+TMZ+GNP group was found to have the least mean SF {76.8, (range 50.4 - 92.9)}. The mean (+/- SD) SF in the RT vs RT+GNP group was 88.3 (+/- 11.4) vs 84.5 (+/- 13.3); TMZ vs TMZ+GNP group was 85.1 (+/- 7.2) vs 83.6 (+/- 7.9); and RT+TMZ vs RT+TMZ+GNP group was 77.9 (+/- 12.2) vs 76.8 (+/- 12.4), respectively. Thus, the mean difference in the SF achieved due to addition of GNPs to RT, TMZ, RT+TMZ was 3.79 (p-value 0.001), 1.47 (p-value 0.001), and 1.06 (p-value 0.011), respectively, with statistical significance. More so, this beneficial effect was pronounced in the samples with high proliferation index (HPI) (PDT <72 hrs, n = 13) than in those with low proliferation index (LPI) (PDT >72 hrs, n = 23), with statistical significance. Although the GNPs were found to be advantageous in the IDH positive samples (n = 11) when compared to the IDH negative samples (n = 14), the results were not statistically significant. Apoptosis, a mechanism of tumor cell death, has been confirmed using western blotting technique in our study. Our study is the first to demonstrate that GNPs could potentially be used to enhance the sensitivity of the human glioma tumors to radiotherapy and chemotherapy. Future larger, in vivo studies are needed to confirm our study findings.
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