From the Guidelines
Saphonications, or the process of loading therapeutic cargos into extracellular vesicles (EVs), is most effectively achieved through electroporation, which has been shown to have a high loading efficiency of up to 20% in some studies 1. When considering the loading of EVs with therapeutic cargos, several methods can be employed, including passive loading, sonication, and chemical permeabilization using detergents such as saponin. However, electroporation stands out as a widely applied and effective method, used in approximately 75% of EV loading studies covered in a recent review 1. Some key points to consider when using electroporation for EV loading include:
- The efficiency of this method is heavily dependent on factors such as EV composition, cargo properties, and electroporation parameters like voltage, pulse length, and pulse number 1.
- Cargo size is also an important factor, with smaller molecules being more easily loaded than larger ones 1.
- The use of electroporation can result in the aggregation of EVs and their cargos, which can affect the accuracy of loading efficiency estimations 1.
- The effects of electroporation on EV integrity and bioactivity are still not fully understood and require further study 1. In contrast to electroporation, sonication has also been used to load EVs, with reported loading efficiencies ranging from 26% to 28% for certain cargos 1. However, this method can be limited by the need for specialized equipment and the potential for cargo degradation or aggregation 1. Chemical permeabilization using detergents like saponin has also been explored, with reported loading efficiencies of up to 18.5% for certain cargos 1. However, this method can be limited by the difficulty of removing residual detergent from EV solutions, which can affect downstream measurements and applications 1. Overall, while various methods can be used to load EVs with therapeutic cargos, electroporation remains a widely used and effective approach, with a high loading efficiency and relatively simple protocol 1.
From the Research
Saphonications Treatment Options
- Various treatment options are available for saphonications, including surgery, endovenous laser ablation (EVLA), ultrasound-guided foam sclerotherapy (UGFS), and sclerotherapy 2, 3, 4, 5, 6
- A study published in 2011 found that minimally invasive techniques, such as EVLA and UGFS, have a tendency towards better results than surgery in the treatment of insufficient small saphenous vein (SSV) 2
- Another study published in 1998 found that the combination of high saphenous ligation and sclerotherapy is effective for patients with saphenofemoral incompetence (SFI) and/or saphenopopliteal incompetence (SPI), while sclerotherapy alone is better for patients without SFI or SPI 3
Treatment Efficacy and Safety
- A study published in 2018 found that applying pre-terminal great saphenous vein interruption to UGFS achieved an occlusion rate at one year similar to that of endovenous thermal ablation, with minimal complications 4
- A study published in 2024 found that combining EVLA and UGFS is a safe and effective treatment for patients with chronic venous insufficiency (CVI) secondary to varicose veins and saphenous trunk incompetence, with a low rate of adverse reactions 5
- A systematic review published in 2009 found that all treatments for varicose veins, including conservative therapy, sclerotherapy, phlebectomy, endovenous laser therapy, radiofrequency ablation, and surgery, have varying levels of effectiveness and safety, and that the type of varicose vein should govern the intervention of choice 6
Treatment Outcomes
- Studies have shown that treatment outcomes for saphonications vary depending on the treatment modality and patient characteristics, with some treatments showing better results in the short-term and others in the long-term 2, 3, 4, 5, 6
- A study published in 2024 found that the saphenous and tributaries closure rate at 30 days, 1 year, and 4 years was 99.1%, 98.3%, and 97.9%, respectively, for patients treated with EVLA and UGFS 5