However, several other tested embolization materials can also reduce the regional blood flow [3, 11, 12]. The advantage of DMS compared to other occluding embolization materials may be probably due to its dynamic effects caused by the mechanism of the degradation processes. Here, we could show that the stepwise degradation processes of DSM via α-amylase lead to temporally blood-flow-shiftings caused by a negative pressure in the occluded blood Inhibitors,research,lifescience,medical vessels. The remaining degraded DSM material as well as the persisting occlusion effect of DSM leads to increasing arterial pressure. As a result, the blood flow centralizes in the

side-arms of the precapillary system. As a result a negative pressure is created, which leads to a temporally reciprocal blood flow via some of the side-arms of the major blood vessels. These forward and backward movements happened several times leading to increased contact frequency of the drug within the tumor tissue and thus can explain the advantageous effects of using DSM in TACE. The variability of the arterial

blood Inhibitors,research,lifescience,medical flow caused by dynamic changes in the DSM degradation processes could also be demonstrated by Civalleri and coworkers [31]. They could show that the use of DSM causes flow redistribution towards the hypovascular areas. When using the drug alone, only very low drug concentrations reach the hypovascular regions in Inhibitors,research,lifescience,medical spite of a comparably high initial dose leading to the suggestion that cancer cells within this area may probably lead to disease progression [31]. Beside the above described effects, it is well known that the use of DSM causes much less postembolization syndrome than using other common embolization material [32, 33]. By analysing the microscopic pictures of the present study, one can suppose that this effect Inhibitors,research,lifescience,medical can also be explained by DSM caused visible dynamic changes within the blood vessels leading probably to a shorter ischemia time laps for the healthy or tumor unaffected tissue. Inhibitors,research,lifescience,medical The use of DMS in TACE may also

give the advantage to combine immune therapeutic treatment approaches. Altomonte and coworkers [34] could, for example, demonstrate that injection of recombinant vesicular stomatitis virus vaccine along with DSM (EmboCept) into the hepatic artery of rats with experimental induced HCC leads to a higher accumulation of the virus into the target organ as well as to a higher level of Edoxaban tumor necrosis and improvement of the survival. Furthermore, a combination of DSM with an adenovirus administered through the hepatic area has been shown to result in an efficient and cancer selective gene transfer [35]. During the last decade, immune therapeutic treatment approaches focused mainly on the use of autologous dendritic cells in vaccination strategies in order to induce an antitumor response by activation and induction of this website tumor-specific cytostatic T cells [36]. However, a lot of patients have a functionally impaired immune system due to the previous applied cytostatic drugs.