What is electroporation?

ELECTROPORATION

Electroporation is a physical phenomenon that leads to the permeabilisation of cell membranes through the application of electrical pulses.

It can be reversible when permeabilisation is temporary, or irreversible when it results in cell death following irreparable damage to the cell membrane.

Reversible
electroporation

Irreversible
electroporation

Reversible
electroporation

Irreversible
electroporation

REVERSIBLE ELECTROPORATION

Reversible electroporation allows molecules that would not normally be able to cross the cell membrane due to their properties (water solubility, large size) to enter the cell and perform their function.

Clinical applications of reversible electroporation include:

Electrochemotherapy
Electrosclerotherapy
Electro-gene-transfer

Electrochemotherapy

Electrochemotherapy uses reversible electroporation to introduce a low dose of a chemotherapy drug (Bleomycin or Cisplatin) into the tumour tissue, administered intravenously or intratumourally.

The electrical pulses are generated by Cliniporator^® and Cliniporator^® VITAE and applied directly to the tumour tissue by means of specific needle electrodes that allow the treatment of different anatomical sites, both superficial and deep-seated.

Once the chemotherapy drug has entered the tumour cell, it causes death by apoptosis at the time of mitotic division. This results in selective cell death of only those tumour cells with a high proliferation rate. Tumour nodules disappear 30-60 days after treatment.

Unlike common thermal ablation, electrochemotherapy is a non-thermal ablative method because the mechanism of action that causes tumour death is mediated only by the effect of the drug. The procedure does not raise the temperature of the electroporated tissue, therefore the adjacent healthy tissue and / or included in the treatment area is completely preserved.

Electrosclerotherapy

The electrosclerotherapy procedure is technically similar to that of electrochemotherapy, but it differs in the following respects:

Clinical indication: superficial and/or deep-seated vascular malformations
Drug used: bleomycin only
Route of administration: intralesional only

Electrosclerotherapy leads to a significant volume reduction of the vascular malformation thanks to the sclerosing and cytostatic effect of bleomycin.

Electro-gene-transfer

The possibility of transiently permeabilising the cell membrane by electroporation is successfully employed for the transfer of genetic material. Specific plasmids are delivered into cells (muscle or dermal), transcribed and translated, leading to protein secretion.

There are numerous fields of application for electro-gene-transfer:

Prophylactic Vaccines: oncology, infectious diseases
Therapeutic Vaccines: oncology, infectious diseases
Immunostimulant Therapies: oncology
Gene Therapies: congenital diseases (glycogenosis, psoriasis), degenerative maculopathy.

IRREVERSIBLE ELECTROPORATION

Irreversible electroporation (IRE) is a non-thermal tissue ablation modality.

Unlike reversible electroporation, it acts through the delivery of numerous high voltage electrical pulses that create permanent nano-pores in the cell membrane, altering homeostasis. Disruption of cellular homeostasis initiates an apoptotic process that leads to cell death.

This procedure does not involve the administration of any chemotherapy drugs, so the effects are exclusively physical.

IRE is mainly used in oncology for ablation of deep organs (liver, pancreas) and, unlike electrochemotherapy, it's not indicated for the treatment of skin and bone lesions.

Because of the specific advantages of this non-thermal ablation procedure, IRE has recently been used in the treatment of atrial fibrillation within clinical trials.