Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Scientific Reports
  • View all journals
  • Search
  • My Account Login
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. scientific reports
  3. articles
  4. article
Safety evaluation of a ketamine–dodecyl maltoside combination using angiogenesis and embryonic development models
Download PDF
Download PDF
  • Article
  • Open access
  • Published: 03 April 2026

Safety evaluation of a ketamine–dodecyl maltoside combination using angiogenesis and embryonic development models

  • Sourour Idoudi1,
  • Arij Fouzat Hassan1,
  • Hadeel Kheraldine2,
  • Leena Amine3,
  • Khalid Alansari2,3,4,
  • Hamda Al-Thawadi2,
  • Abdelbary Elhissi1,
  • Ousama Rachid1 &
  • …
  • Alaaldin M. Alkilany1 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Biotechnology
  • Cancer
  • Cell biology
  • Developmental biology
  • Drug discovery

Abstract

Ketamine (KET) exhibits potential anticancer activity, with enhanced cytotoxicity against melanoma cells when combined with the permeation enhancer dodecyl maltoside (DDM). To support clinical translation, this study evaluated the embryotoxicity, effects on angiogenesis, and cytocompatibility of KET, DDM, and their combination (KET + DDM) using a chicken embryo model. The chorioallantoic membrane (CAM) assay was used to assess angiogenesis following treatment with KET (1000 µM), DDM (19.6 µM), or KET + DDM in fertilized eggs. Embryonic survival and morphology were monitored for five days. Quantitative PCR analysis of heart, lung, kidney, and brain tissues evaluated apoptosis-related genes (Caspase 3, Caspase 8, Caspase 9, BAX) and VEGF expression. Cytocompatibility was examined in primary embryonic fibroblasts (EFBs) using AlamarBlue assays and morphological assessment. The results showed no significant differences in vascular density, vessel length, or branching in the CAM assay across all treatments. Embryos treated with KET or KET + DDM showed normal survival and morphology, while DDM alone reduced viability. Apoptotic and angiogenic gene expression remained unchanged in major organs. In vitro, KET and KET + DDM did not reduce EFB viability or alter morphology. Overall, KET and KET + DDM did not produce detectable adverse effects in embryonic and cellular models, preserving angiogenesis and development. Notably, the KET + DDM combination showed no detectable adverse effects, supporting the preliminary safety of this combination for further anticancer investigation.

Data availability

Data is provided within the manuscript.

References

  1. Saito, J. et al. Anti-cancer effect of ketamine in comparison with MK801 on neuroglioma and lung cancer cells. Eur. J. Pharmacol. ;945(175580). (2023).

  2. Zhou, X. et al. Ketamine induces apoptosis in lung adenocarcinoma cells by regulating the expression of CD69. Cancer Med. 7 (3), 788–795 (2018).

    Google Scholar 

  3. He, G. N. et al. Ketamine induces ferroptosis of liver cancer cells by targeting lncRNA PVT1/miR-214-3p/GPX4. Drug Des. Devel Ther. 15, 3965–3978 (2021).

    Google Scholar 

  4. Zhao, S., Shao, L., Wang, Y., Meng, Q. & Yu, J. Ketamine exhibits anti-gastric cancer activity via induction of apoptosis and attenuation of PI3K/Akt/mTOR. Arch. Med. Sci. 16 (5), 1140–1149 (2019).

    Google Scholar 

  5. Li, H. et al. Ketamine suppresses proliferation and induces ferroptosis and apoptosis of breast cancer cells by targeting KAT5/GPX4 axis. Biochem. Biophys. Res. Commun. [Internet]. 585, 111–116. (2021). Available from: https://doi.org/10.1016/j.bbrc.2021.11.029

  6. Malsy, M. et al. Effects of ketamine, s-ketamine, and MK 801 on proliferation, apoptosis, and necrosis in pancreatic cancer cells. BMC Anesthesiol [Internet]. 15(1), 1–7. (2015). Available from: https://doi.org/10.1186/s12871-015-0076-y

  7. Niwa, H., Furukawa, K. I., Seya, K. & Hirota, K. Ketamine suppresses the proliferation of rat C6 glioma cells. Oncol. Lett. 14 (4), 4911–4917 (2017).

    Google Scholar 

  8. Idoudi, S. et al. Ketamine and dodecyl maltoside synergy as a potential topical therapeutic approach for melanoma. Sci. Reports [Internet]. 15(1), 37887 Available from: https://www.nature.com/articles/s41598-025-21668-1

  9. Gholizadeh, A., Amjad-Iranagh, S. & Halladj, R. Assessing the Interaction between Dodecylphosphocholine and Dodecylmaltoside Mixed Micelles as Drug Carriers with Lipid Membrane: A Coarse-Grained Molecular Dynamics Simulation. ACS Omega [Internet]. (2024). https://pubs.acs.org/doi/full/10.1021/acsomega.4c02551

  10. Petersen, S. B. et al. Evaluation of alkylmaltosides as intestinal permeation enhancers: Comparison between rat intestinal mucosal sheets and Caco-2 monolayers. Eur. J. Pharm. Sci. 47 (4), 701–712 (2012).

    Google Scholar 

  11. Yu, Y. Q., Yang, X., Wu, X. F., Fan, Y. & Bin Enhancing Permeation of Drug Molecules Across the Skin via Delivery in Nanocarriers: Novel Strategies for Effective Transdermal Applications. Front. Bioeng. Biotechnol. 9, 646554 (2021).

    Google Scholar 

  12. Larsen, N. W. et al. Interactions of oral permeation enhancers with lipid membranes in simulated intestinal environments. Int. J. Pharm. 654, 123957 (2024).

    Google Scholar 

  13. Aguirre-Ramírez, M., Silva-Jiménez, H., Banat, I. M. & Díaz De Rienzo, M. A. Surfactants: physicochemical interactions with biological macromolecules. Biotechnol Lett. [Internet]. 43(3), 523. https://pmc.ncbi.nlm.nih.gov/articles/PMC7872986/

  14. Tirumalasetty, P. P. & Eley, J. G. Evaluation of Dodecylmaltoside as a Permeability Enhancer for Insulin Using Human Carcinoma Cells. J. Pharm. Sci. 94 (2), 246–255 (2005).

    Google Scholar 

  15. Michael Danielsen, E. & Hansen, G. H. Probing the Action of Permeation Enhancers Sodium Cholate and N-dodecyl-β-D-maltoside in a Porcine Jejunal Mucosal Explant System. Pharm. 10(4), 172. (2018). https://www.mdpi.com/1999-4923/10/4/172/htm

  16. Gradauer, K. et al. Dodecylmaltoside Modulates Bicellular Tight Junction Contacts to Promote Enhanced Permeability. Mol. Pharm. [Internet]. 14(12), 4734–4740. https://pubs.acs.org/doi/abs/https://doi.org/10.1021/acs.molpharmaceut.7b00297

  17. Zhang, T., Li, M., Han, X., Nie, G. & Zheng, A. Effect of Different Absorption Enhancers on the Nasal Absorption of Nalmefene Hydrochloride. AAPS PharmSciTech ;23(5), 143 PMID: 35578146. doi: 10.1208/s12249-022-02252-6 (2022).

  18. Xia, Y. et al. Performance and toxicity of different absorption enhancers used in the preparation of Poloxamer thermosensitive in situ gels for ketamine nasal administration. Drug Dev Ind Pharm [Internet]. May 3 [cited 2024 Jan 2];46(5):697–705. Available from: https://www.tandfonline.com/doi/abs/ (2020). https://doi.org/10.1080/03639045.2020.1750625

  19. Steyn, J. D. et al. Evaluation of Drug Permeation Enhancement by Using In Vitro and Ex Vivo Models. Pharm [Internet]. 18(2), 195. https://www.mdpi.com/1424-8247/18/2/195/htm

  20. Crasta, A. et al. Transdermal drug delivery system: A comprehensive review of innovative strategies, applications, and regulatory perspectives. OpenNano 24, 100245 (2025).

    Google Scholar 

  21. Lugano, R., Ramachandran, M. & Dimberg, A. Tumor angiogenesis: causes, consequences, challenges and opportunities. Cell Mol. Life Sci. C [Internet]. 77(9), 1745. (2019). https://pmc.ncbi.nlm.nih.gov/articles/PMC7190605/

  22. Pathak, A., Pal, A. K., Roy, S., Nandave, M. & Jain, K. Role of Angiogenesis and Its Biomarkers in Development of Targeted Tumor Therapies. Stem Cells Int. [Internet]. 2024(1), 9077926. (2024) https://onlinelibrary.wiley.com/doi/full/https://doi.org/10.1155/2024/9077926

  23. Liu, Z. L., Chen, H. H., Zheng, L. L., Sun, L. P. & Shi, L. Angiogenic signaling pathways and anti-angiogenic therapy for cancer. Signal Transduct Target Ther [Internet]. 8(1), 198. (2023) https://www.nature.com/articles/s41392-023-01460-1

  24. Goel, S. et al. Normalization of the vasculature for treatment of cancer and other diseases. Physiol. Rev. [Internet]. 91(3), 1071. (2011). https://pmc.ncbi.nlm.nih.gov/articles/PMC3258432/

  25. Dudley, A. C. & Griffioen, A. W. Pathological angiogenesis: mechanisms and therapeutic strategies. Angiogenes [Internet]. 26(3), 313–347. (2023) https://link.springer.com/article/https://doi.org/10.1007/s10456-023-09876-7

  26. Nowak-Sliwinska, P., Segura, T. & Iruela-Arispe, M. L. The chicken chorioallantoic membrane model in biology, medicine and bioengineering. Angiogenesis [Internet]. 17(4), 779. (2014). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4583126/

  27. Dhayer, M. et al. Implementing Chicken Chorioallantoic Membrane (CAM) Assays for Validating Biomaterials in Tissue Engineering: Rationale and Methods. J. Biomed. Mater Res. Part B Appl. Biomater [Internet]. 112(11), e35496. (2025) https://onlinelibrary.wiley.com/doi/full/https://doi.org/10.1002/jbm.b.35496

  28. Kue, C. S., Tan, K. Y., Lam, M. L. & Lee, H. B. Chick embryo chorioallantoic membrane (CAM): an alternative predictive model in acute toxicological studies for anti-cancer drugs. Exp Anim [Internet]. 64(2), 129. (2026) https://pmc.ncbi.nlm.nih.gov/articles/PMC4427727/

  29. Yuan, Y. J., Xu, K., Wu, W., Luo, Q. & Yu, J. L. Application of the Chick Embryo Chorioallantoic Membrane in Neurosurgery Disease. Int. J. Med. Sci. [Internet]. 11(12), 1275–1281. (2014). http://www.medsci.org1275

  30. Butler, K. S., Brinker, C. J. & Leong, H. S. Bridging the in Vitro to in Vivo gap: Using the Chick Embryo Model to Accelerate Nanoparticle Validation and Qualification for in Vivo studies. ACS Nano [Internet]. 16(12), 19626–19650. https://pubs.acs.org/doi/full/https://doi.org/10.1021/acsnano.2c03990

  31. Fischer, D. et al. The CAM Model—Q&A with Experts. Cancers [Internet]. 15(1), 191. https://www.mdpi.com/2072-6694/15/1/191/htm

  32. Tazawa, H. Adverse effect of failure to turn the avian egg on the embryo oxygen exchange. Respir Physiol. 41 (2), 137–142 (1980).

    Google Scholar 

  33. Kheraldine, H. et al. Naked Poly(amidoamine) Dendrimer Nanoparticles Exhibit Intrinsic Embryotoxicity During the Early Stages of Normal Development. J. Biomed. Nanotechnol. [Internet]. 16(10), 1454–62. (2020) https://nchr.elsevierpure.com/en/publications/naked-polyamidoamine-dendrimer-nanoparticles-exhibit-intrinsic-em/fingerprints/

  34. Zudaire, E., Gambardella, L., Kurcz, C. & Vermeren, S. A Computational Tool for Quantitative Analysis of Vascular Networks. PLoS One [Internet]. 6(11), e27385. (2011). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0027385

  35. Kheraldine, H. et al. Effects of neratinib on angiogenesis and the early stage of the embryo using chicken embryo as a model. Biomol. Biomed. [Internet]. 24(3), 575–81. (2024). https://pubmed.ncbi.nlm.nih.gov/38158791/

  36. Al-Asmakh, M. et al. Dasatinib and PD-L1 inhibitors provoke toxicity and inhibit angiogenesis in the embryo. Biomed. Pharmacother. 134, 111134 (2021).

    Google Scholar 

  37. Palumbo, C., Sisi, F., Checchi, M. CAM Model: Intriguing Natural Bioreactor for Sustainable Research and Reliable/Versatile Testing. Biol. [Internet]. 12(9), 1219. (2023). https://www.mdpi.com/2079-7737/12/9/1219/htm

  38. Yıldırım, A. K., Özgürtaş, E. & İnce, M. E. Anti-angiogenic response of ketamine in the in vitro and in vivo settings. Turkish J. Vasc Surg. 31 (2), 67–71 (2022).

    Google Scholar 

  39. Waschkies, C., Nicholls, F. & Buschmann, J. Comparison of medetomidine, thiopental and ketamine/midazolam anesthesia in chick embryos for in ovo Magnetic Resonance Imaging free of motion artifacts. Sci. Rep. 5 (April), 1–6 (2015).

    Google Scholar 

  40. Lee, C. et al. Vascular endothelial growth factor signaling in health and disease: from molecular mechanisms to therapeutic perspectives. Signal Transduct Target Ther 10(1), 170. (2025) https://www.nature.com/articles/s41392-025-02249-0

  41. Zhao, Y. & Lu, H. A comprehensive description of VEGF-R1/2 small molecule inhibitors as anticancer agents. Bioorg. Chem. 166, 109159 (2025).

    Google Scholar 

  42. Li, Y., Li, J., Zhang, X., Ding, J. & Mao, S. Non-ionic surfactants as novel intranasal absorption enhancers: in vitro and in vivo characterization. Drug Deliv. 23 (7), 2272–2279 (2016).

    Google Scholar 

  43. Hmingthansanga, V. et al. Improved Topical Drug Delivery: Role of Permeation Enhancers and Advanced Approaches. Pharmaceutics [Internet]. 14(12), 2818. https://pmc.ncbi.nlm.nih.gov/articles/PMC9785322/

  44. Wang, Y. et al. Exploring the effects of different types of surfactants on zebrafish embryos and larvae. Sci. Rep. ;5, 10107; doi: 10.1038/srep10107 (2015).

  45. Félix, L. M. et al. Embryonic Stage-Dependent Teratogenicity of Ketamine in Zebrafish (Danio rerio). Chem. Res. Toxicol. 29 (8), 1298–1309 (2016).

    Google Scholar 

  46. Guo, R. et al. Early ketamine exposure results in cardiac enlargement and heart dysfunction in Xenopus embryos. BMC Anesthesiol [Internet]. 16(1), 1–8. (2016). https://doi.org/10.1186/s12871-016-0188-z

  47. Sedlacek, J. Influence of ketamine on the spontaneous motility of chick embryos and its development. Physiol. Res. 41 (6), 445–449 (1992).

    Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the financial support and Open Access funding provided by Qatar University. The authors also thank Mazzraty Poultry, Qatar, for their support in providing and delivering fertilized eggs. In addition, the authors acknowledge the Biomedical Research Center (BRC), Qatar University, for providing the necessary facilities to conduct this work.

Funding

Dr. Alkilany’s Laboratory is supported by funding from Qatar University and the Qatar Research, Development, and Innovation (QRDI) Council. Open Access funding is provided by Qatar University.

Author information

Authors and Affiliations

  1. Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar

    Sourour Idoudi, Arij Fouzat Hassan, Abdelbary Elhissi, Ousama Rachid & Alaaldin M. Alkilany

  2. College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar

    Hadeel Kheraldine, Khalid Alansari & Hamda Al-Thawadi

  3. Department of Pediatrics Emergency, Sidra Medicine, P.O. Box 26999, Doha, Qatar

    Leena Amine & Khalid Alansari

  4. Weill Cornell, Medical College, P.O. Box 24144, Doha, Qatar

    Khalid Alansari

Authors
  1. Sourour Idoudi
    View author publications

    Search author on:PubMed Google Scholar

  2. Arij Fouzat Hassan
    View author publications

    Search author on:PubMed Google Scholar

  3. Hadeel Kheraldine
    View author publications

    Search author on:PubMed Google Scholar

  4. Leena Amine
    View author publications

    Search author on:PubMed Google Scholar

  5. Khalid Alansari
    View author publications

    Search author on:PubMed Google Scholar

  6. Hamda Al-Thawadi
    View author publications

    Search author on:PubMed Google Scholar

  7. Abdelbary Elhissi
    View author publications

    Search author on:PubMed Google Scholar

  8. Ousama Rachid
    View author publications

    Search author on:PubMed Google Scholar

  9. Alaaldin M. Alkilany
    View author publications

    Search author on:PubMed Google Scholar

Contributions

S.I.: Data curation, Formal analysis, Writing—original draft. H.K.: Data curation, Formal analysis. A.H.F.: Data curation, Formal analysis. L.A.: Supervision, Writing—review and editing. K.A.A.: Supervision, Writing—review and editing. H.A.: Supervision, Writing—review and editing. A.E.: Supervision, Writing—review and editing. O.R.: Supervision, Writing—review and editing. A.M.A.: Conceptualization, Main supervision, Validation, Funding acquisition, Methodology, Project administration, Resources, Writing—review and editing. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Alaaldin M. Alkilany.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Material 1 (download XLSX )

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Idoudi, S., Hassan, A.F., Kheraldine, H. et al. Safety evaluation of a ketamine–dodecyl maltoside combination using angiogenesis and embryonic development models. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46828-9

Download citation

  • Received: 02 February 2026

  • Accepted: 27 March 2026

  • Published: 03 April 2026

  • DOI: https://doi.org/10.1038/s41598-026-46828-9

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • Ketamine
  • Dodecyl maltoside
  • Angiogenesis
  • Embryogenesis
  • Chorioallantoic membrane (CAM)
  • Cell viability
Download PDF

Advertisement

Explore content

  • Research articles
  • News & Comment
  • Collections
  • Subjects
  • Follow us on Facebook
  • Follow us on X
  • Sign up for alerts
  • RSS feed

About the journal

  • About Scientific Reports
  • Contact
  • Journal policies
  • Guide to referees
  • Calls for Papers
  • Editor's Choice
  • Journal highlights
  • Open Access Fees and Funding

Publish with us

  • For authors
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Scientific Reports (Sci Rep)

ISSN 2045-2322 (online)

nature.com footer links

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2026 Springer Nature Limited

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer