Co₉ Se₈ nanoplates as a new theranostic platform for photoacoustic/magnetic resonance dual-modal-imaging-guided chemo-photothermal combination therapy

Alkaline Phosphatase-Triggered Self-Assembly of Near-Infrared Nanoparticles for the Enhanced Photoacoustic Imaging of Tumors

Photoacoustic (PA) imaging is advantageous for the diagnosis of superficial cancer with high spatial resolution. However, to the best of our knowledge, using an alkaline phosphatase (ALP)-activatable probe for the enhanced PA imaging of tumors has not been reported. In this work, we rationally designed a NIR probe IR775-Phe-Phe-Tyr(H₂PO₃)-OH (1P) for PA imaging ALP activity in vitro and in tumor. Under the catalysis of ALP, 1P was efficiently converted to IR775-Phe-Phe-Tyr-OH (1), which self-assembled into the nanoparticles 1-NPs. The formation of 1-NPs induced a 6.4-fold enhancement of the 795 nm PA signal of 1P. In vivo tumor PA imaging results indicated that, compared to that in the ALP inhibitor-treated control group, PA contrast in the experimental group enhanced 2.3 folds at 4 h after 1P injection. By replacing the Phe-Phe-Tyr(H₂PO₃)-OH motif in 1P with other enzyme-cleavable ones, we hope that more PA probes could be developed for the precise diagnoses of their corresponding cancers in the near future.

Optimization of Red Luminescent Intensity in Eu3+-Doped Lanthanide Phosphors Using Genetic Algorithm

In this research, four steps including synthesis experiment, brightness evaluation, optimized calculation using brightness as fitness reference, and new calculated composition for the next preparation have been proceeded to find the brightest Eu³⁺ doped phosphors combined with chemical experiments and genetic algorithm (GA) calculation. The evolutionary operations, such as elitism, selection, crossover, and mutation, are applied to the compound combination. Feasible optimized combination would be obtained until the phosphor is found to be satisfactory. Through GA calculation and thd experimental process, the final luminescence enhancement factor of the optimal phosphor is up to 141% compared with the best one in the first generation. Thus, the GA calculation could be well applied to combinatorial chemistry to find the better phosphor. Additionally, the optimized phosphor is potentially applied as the fingerprint detection nanoparticle and dual-modal imaging agent of the CT/luminescent agent with high penetration and resolution.

Near-Infrared Photoactivatable Nitric Oxide Donors with Integrated Photoacoustic Monitoring

Photoacoustic (PA) tomography is a noninvasive technology that utilizes near-infrared (NIR) excitation and ultrasonic detection to image biological tissue at centimeter depths. While several activatable small-molecule PA sensors have been developed for various analytes, the use of PA molecules for deep-tissue analyte delivery and monitoring remains an underexplored area of research. Herein, we describe the synthesis, characterization, and in vivo validation of photoNOD-1 and photoNOD-2, the first organic, NIR-photocontrolled nitric oxide (NO) donors that incorporate a PA readout of analyte release. These molecules consist of an aza-BODIPY dye appended with an aryl N-nitrosamine NO-donating moiety. The photoNODs exhibit chemostability to various biological stimuli, including redox-active metals and CYP450 enzymes, and demonstrate negligible cytotoxicity in the absence of irradiation. Upon single-photon NIR irradiation, photoNOD-1 and photoNOD-2 release NO as well as rNOD-1 or rNOD-2, PA-active products that enable ratiometric monitoring of NO release. Our in vitro studies show that, upon irradiation, photoNOD-1 and photoNOD-2 exhibit 46.6-fold and 21.5-fold ratiometric turn-ons, respectively. Moreover, unlike existing NIR NO donors, the photoNODs do not require encapsulation or multiphoton activation for use in live animals. In this study, we use PA tomography to monitor the local, irradiation-dependent release of NO from photoNOD-1 and photoNOD-2 in mice after subcutaneous treatment. In addition, we use a murine model for breast cancer to show that photoNOD-1 can selectively affect tumor growth rates in the presence of NIR light stimulation following systemic administration.

Ultrafast synthesis of ultrasmall polyethylenimine-protected AgBiS2 nanodots by "rookie method" for in vivo dual-modal CT/PA imaging and simultaneous photothermal therapy

Developing a biocompatible nanotheranostic platform integrating diagnostic and therapeutic functions is a great prospect for cancer treatment. However, it is still a great challenge to synthesize nanotheranostic agents using an ultra-facile method. In the research reported here, ultrasmall polyethylenimine-protected silver bismuth sulfide (PEI-AgBiS2) nanodots were successfully synthesized using an ultra-facile and environmentally friendly strategy (1 min only at room temperature), which could be described as a "rookie method". PEI-AgBiS2 nanodots show good monodispersity and biocompatibility. For the first time, PEI-AgBiS2 nanodots were reported as a powerful and safe nanotheranostic agent for cancer treatment. PEI-AgBiS2 nanodots exhibit excellent computed tomography (CT) and photoacoustic (PA) dual-modal imaging ability, which could effectively guide photothermal cancer therapy. Furthermore, PEI-AgBiS2 nanodots exhibit a high photothermal conversion efficiency (η = 35.2%). The photothermal therapy (PTT) results demonstrated a highly efficient tumor ablation ability. More importantly, the blood biochemistry and histology analyses verify that the PEI-AgBiS2 nanodots have negligible long-term toxicity. This work highlights that PEI-AgBiS2 nanodots produced using this extremely effective method are a high-performance and safe PTT agent. These findings open a new gateway for synthesizing nanotheranostic agents by using this ultra-facile method in the future.

A redox-activated theranostic nanoagent: toward multi-mode imaging guided chemo-photothermal therapy

Development of tumor microenvironment responsive and modulating theranostic nano-systems is of great importance for specific and efficient cancer therapy. Herein, we report a redox-sensitive nanoagent combining manganese dioxide (MnO2) and gold nanoshell coated silicon nanoparticles for synergistic chemo-photothermal therapy of hypoxia solid tumors. In highly reducing tumor tissues, the outer MnO2 nanosheet with the loaded drug would be dissociated by intracellular glutathione (GSH), resulting in on-demand drug release, as well as generating Mn2+ ions which provided high contrast magnetic resonance imaging (MRI), and fluorescence imaging (FI) in vitro and in vivo. While upon near-infrared (NIR) light irradiation, the gold nanoshell modulated the hypoxic tumor microenvironment via increasing blood flow, achieving enhanced photothermal therapy (PTT) and chemotherapy. After tail vein injection into tumor-bearing mice and monitoring in real time, the intelligent redox-activated nanoagent exhibited high tumor accumulation and powerful synergistic chemo-photothermal therapy efficiency. The proposed work developed a noninvasive strategy to modulate the tumor microenvironment and enhance the anticancer therapeutic effect. We believe that this single nano-platform exhibits promising potential as a comprehensive theranostic agent to enhance the efficacies of synergistic cancer therapy.

Near-Infrared II Dye-Protein Complex for Biomedical Imaging and Imaging-Guided Photothermal Therapy

The development of novel biodegradable and nontoxic fluorophores that integrate diagnosis and therapy for effective cancer treatment has obtained tremendous attention in the past decades. In this report, water-soluble and biocompatible small-molecule near-infrared II (NIR-II) fluorescent dye H2a-4T complexed with fetal bovine serum (FBS) and Cetuximab proteins with excellent optical properties and targeting ability is prepared. High spatial and temporal resolution imaging of hind limb vasculature and the lymphatic system of living mice using H2a-4T@FBS complex is demonstrated in precise NIR-II imaging-guided sentinel lymph node surgery. More importantly, H2a-4T@Cetuximab complex not only exhibits a remarkable cell-killing ability but also achieves highly active tumor targeting efficiency for epidermal growth factor receptor, overexpressing colorectal cancer which is beneficial to in vivo NIR-II fluorescent imaging-guided photothermal therapy of colon tumors. To the best of our knowledge, it is the first time that the concept of light-harvesting complex is exploited for enhancing the NIR-II signals and photothermal energy conversion in molecule-protein complex theranostic agent, making them a promising candidate for future clinical applications in cancer theranostics.

Self-Quenched Metal-Organic Particles as Dual-Mode Therapeutic Agents for Photoacoustic Imaging-Guided Second Near-Infrared Window Photochemotherapy

The nanosized metal-organic particles (NMOPs) recently have attracted tremendous attentions in biomedical applications. However, few studies have developed metal-organic nanoparticles (NMOPs) as near-infrared (NIR) II phototherapeutic agents and as Fenton-like agents for cancer theranostics. Herein, directly using organic dye and Cu(II)-ion complexes to construct NMOPs, as dual-mode therapeutic agent for PA imaging-guided photochemotherapy in NIR II window, is reported. The NMOPs are simply an assembly of Cu(II) ion and tetrahydroxyanthraquinone (THQ) complexes [Cu(II)-THQ] _n through the coordination effect, van der Waals force, and π-π interactions. After modification of polyethylene glycol (PEG-(NH₂)₂), the obtained Cu-THQNPs endow excellent biocompatibility and stability in physiological conditions. Because of the strong absorption at NIR II window and photoinduced electrontransfer (PET) mechanism, the Cu-THQNPs not only acted as an excellent photothermal agent with extremely high light-to-heat conversion ability (51.34%) at 1064 nm for phototherapy but also explored as the PA contrast agent for precisely tracking and guiding the therapy in vivo. Most strikingly, our Cu-THQNPs can be degraded by tumor-specific acidic-cleaving of the coordination bonds and follow by the slow release of Cu(II) into tumors, which can act as Fenton-like agents to generate ^•OH from H₂O₂ for enhancing the antitumor efficacy in vivo. With almost 100% prevention of the tumor growth for ca. 14 days and no obvious toxicity based on blood biochemical/histological analysis, this work highlights the Cu-THQNPs as an efficient NIR II therapeutic agent for precise cancer theranostics.

Porous cobalt sulfide hollow nanospheres with tunable optical property for magnetic resonance imaging-guided photothermal therapy

Transition-metal chalcogenides with an imaging element and tunable optical property are strongly desired as ideal high-efficiency photothermal theranostic agents to diagnose and eliminate tumors. Herein, we report on a one-pot solvothermal strategy to synthesize various porous cobalt sulfide hollow nanospheres (PCSH NSs) and elucidate the relation between PCSH NSs and their optical absorption as a guide to obtain optimal photothermal therapy (PTT) agents. After PEG modification, PEG-PCSH NSs show superexcellent photothermal conversion efficiency (∼70.1%) which is higher than that of binary transition-metal chalcogenides materials reported to date. A low dose (100 μL, 25 ppm) could completely ablate tumors under an 808 nm laser power of 0.7 W cm-2, reducing in vivo long-term residual agent content and thus lowering the possibility of side effects. Additionally, they also exhibit excellent biocompatibility, good photostability and utility for magnetic resonance imaging. Our results indicate that PCSH NSs can be considered as an outstanding PTT agent and give guidance towards the design of other photothermal theranostic agents.

Two-dimensional tellurium nanosheets for photoacoustic imaging-guided photodynamic therapy

We report the synthesis of two-dimensional Te nanosheets through a facile liquid exfoliation method. The as-synthesized Te nanosheets can produce reactive oxygen species under light irradiation and show high photoacoustic imaging performance due to their strong near-infrared absorbance, and can be engineered as a nanoplatform for simultaneous photoacoustic imaging and photodynamic therapy.

An easy-to-fabricate clearable CuS-superstructure-based multifunctional theranostic platform for efficient imaging guided chemo-photothermal therapy

Despite drug delivery systems (DDSs) receiving ever-increasing attention, development of a simple, effective, sensitive and clearable drug delivery and multifunctional theranostic nanoplatform for cancer therapy is still highly desirable and remains a challenge. Herein, using a one-step solvothermal method, hollow acanthosphere-like CuS superstructures assembled from ∼10 nm nanoparticles (NPs) were successfully obtained and used as an efficient drug delivery and theranostic platform for photoacoustic (PA) and infrared (IR) thermal imaging-guided cancer combination therapy. The special hollow characteristic of CuS superstructures with mesoporous shells and large cavities grants them high drug loading capacity; they demonstrate near-infrared (NIR)/pH stimuli-sensitive drug release and pronounced synergetic effects of chemo-photothermal therapy both in vitro and in vivo. In particular, our as-fabricated hollow loose CuS superstructures, with easily breakable characteristic, are biodegradable and able to be cleared from the body when their therapy task is completed. This CuS-superstructure-based clearable drug delivery and "all-in-one" cancer theranostic platform might provide possibilities for improving therapeutic efficacy and minimizing adverse effects.

Carbon-based hybrid nanogels: a synergistic nanoplatform for combined biosensing, bioimaging, and responsive drug delivery

Nanosized crosslinked polymer networks, named as nanogels, are playing an increasingly important role in a diverse range of applications by virtue of their porous structures, large surface area, good biocompatibility and responsiveness to internal and/or external chemico-physical stimuli. Recently, a variety of carbon nanomaterials, such as carbon quantum dots, graphene/graphene oxide nanosheets, fullerenes, carbon nanotubes, and nanodiamonds, have been embedded into responsive polymer nanogels, in order to integrate the unique electro-optical properties of carbon nanomaterials with the merits of nanogels into a single hybrid nanogel system for improvement of their applications in nanomedicine. A vast number of studies have been pursued to explore the applications of carbon-based hybrid nanogels in biomedical areas for biosensing, bioimaging, and smart drug carriers with combinatorial therapies and/or theranostic ability. New synthetic methods and structures have been developed to prepare carbon-based hybrid nanogels with versatile properties and functions. In this review, we summarize the latest developments and applications and address the future perspectives of these carbon-based hybrid nanogels in the biomedical field.

Evans Blue Derivative-Functionalized Gold Nanorods for Photothermal Therapy-Enhanced Tumor Chemotherapy

Chemotherapy is a standard care for cancer management, but the lack of tumor targeting and high dose-induced side effects still limit its utility in patients. Here, we report a chemotherapy combined with photothermal therapy (PTT) for enhanced cancer ablation by functionalization of gold nanorods (GNRs) with a novel small molecule named truncated Evans blue (tEB). On the basis of the high binding affinity of tEB with albumin, an Abraxane-like nanodrug, human serum albumin/hydroxycamptothecin (HSA/HCPT), was further complexed with GNR-tEB. This formed an HCPT/HSA/tEB-GNR (HHEG) with excellent biostability and biocompatibility. With photoacoustic and fluorescence imaging, we observed HHEG tumor targeting, which is mediated by enhanced permeability retention effect. The accumulation of HHEG peaked in tumor at 12 h postinjection. Moreover, HHEG can effectively ablate tumor growth with laser illumination via chemo/thermal therapy after intravenous administration into SCC7 tumor. This combination is much better than chemotherapy or PTT alone. Collectively, we constructed a chemo/thermal therapy nanostructure based on a tEB-modified GNR for better tumor treatment effect. The use of tEB in gold nanoparticles can facilitate many new approaches to design hybrid nanoparticles.

Monolayer Nanosheets with an Extremely High Drug Loading toward Controlled Delivery and Cancer Theranostics

2D nanomaterials have attracted considerable research interest in drug delivery systems, owing to their intriguing quantum size and surface effect. Herein, Gd³⁺ -doped monolayered-double-hydroxide (MLDH) nanosheets are prepared via a facile bottom-up synthesis method, with a precisely controlled composition and uniform morphology. MLDH nanosheets as drug carrier are demonstrated in coloading of doxorubicin and indocyanine green (DOX&ICG), with an ultrahigh drug loading content (LC) of 797.36% and an encapsulation efficiency (EE) of 99.67%. This is, as far as it is known, the highest LC level at nearly 100% of EE among previously reported 2D drug delivery systems so far. Interestingly, the as-prepared DOX&ICG/MLDH composite material shows both pH-controlled and near-infrared-irradiation-induced DOX release, which holds a promise in stimulated drug release. An in vivo dual-mode imaging, including near-infrared fluorescence and magnetic resonance imaging, enables a noninvasive visualization of distribution profiles at the tumor site. In addition, in vitro and in vivo therapeutic evaluations demonstrate an excellent trimode synergetic anticancer activity and superior biocompatibility of DOX&ICG/MLDH. Therefore, MLDH nanosheets provide new perspectives in the design of multifunctional nanomedicine, which shows promising applications in controlled drug delivery and cancer theranostics.

Intracellular Mechanistic Understanding of 2D MoS2 Nanosheets for Anti-Exocytosis-Enhanced Synergistic Cancer Therapy

Emerging two-dimensional (2D) nanomaterials, such as transition-metal dichalcogenide (TMD) nanosheets (NSs), have shown tremendous potential for use in a wide variety of fields including cancer nanomedicine. The interaction of nanomaterials with biosystems is of critical importance for their safe and efficient application. However, a cellular-level understanding of the nano-bio interactions of these emerging 2D nanomaterials ( i. e., intracellular mechanisms) remains elusive. Here we chose molybdenum disulfide (MoS2) NSs as representative 2D nanomaterials to gain a better understanding of their intracellular mechanisms of action in cancer cells, which play a significant role in both their fate and efficacy. MoS2 NSs were found to be internalized through three pathways: clathrin → early endosomes → lysosomes, caveolae → early endosomes → lysosomes, and macropinocytosis → late endosomes → lysosomes. We also observed autophagy-mediated accumulation in the lysosomes and exocytosis-induced efflux of MoS2 NSs. Based on these findings, we developed a strategy to achieve effective and synergistic in vivo cancer therapy with MoS2 NSs loaded with low doses of drug through inhibiting exocytosis pathway-induced loss. To the best of our knowledge, this is the first systematic experimental report on the nano-bio interaction of 2D nanomaterials in cells and their application for anti-exocytosis-enhanced synergistic cancer therapy.

Ultra-high loading of sinoporphyrin sodium in ferritin for single-wave motivated photothermal and photodynamic co-therapy

In this work, a potent photosensitizer, sinoporphyrin sodium (DVDMS), was loaded into RGD-modified ferritin (R-Fn) nanocages by a rapid, scalable and versatile approach for imaging guided photodynamic and photothermal (PTT/PDT) co-therapy. The resulting nanocomposite formed a well-defined nanocage with a photosensitizer loading capacity as high as 66.67 wt%, which far exceeds those reported previously. The bioengineered protein nanocage-based nanotheranostics exhibits a remarkably improved tumor treatment effect over DVDMS with good biocompatibility and the potential of clinical translation.

Perfluorooctyl bromide & indocyanine green co-loaded nanoliposomes for enhanced multimodal imaging-guided phototherapy

As a highly biocompatible NIR dye, indocyanine green (ICG) has been widely explored for cancer treatment due to its various energy level transition pathways upon NIR light excitation simultaneously, which leads to different theranostic effects (eg. Photoacoustic (PA) and fluorescence imaging (FL), photodynamic and photothermal therapy (PDT&PTT)). However, the theranostic efficiency of ICG is restricted intrinsically, owing to the competitive relationship of its co-existing imaging and therapeutic effect. Moreover, the extrinsic hypoxia nature of tumor further limits its therapeutic effect, especially for the oxygen-dependent PDT. Herein, perfluorooctyl bromide (PFOB), another biocompatible chemical, was integrated with ICG in a nanoliposome structure via a facile two-step emulsion method. Such an ICG&PFOB co-loaded nanoliposomes (LIP-PFOB-ICG) realized computed tomography (CT) contrast imaging in vivo, providing better anatomical information of tumor in comparison to ICG enabled PA and FL imaging. More importantly, LIP-PFOB-ICG inhibited MDA-MB-231 tumor growth completely via intravenous injection through enhanced PDT&PTT synergistic therapy due to the excellent oxygen carrying ability of PFOB, which effectively attenuated tumor hypoxia, improved the efficiency of collisional energy transfer between ICG and oxygen and reduced the expression of heat shock protein (HSP). As expected, the introduction of PFOB within nanoliposomes with ICG has augmented the theranostic effect of ICG comprehensively, which makes this simple biocompatible liposome-based nanoagent a potential candidate for clinical imaging guided phototherapy of cancer.

Dual Chemodrug-Loaded Single-Walled Carbon Nanohorns for Multimodal Imaging-Guided Chemo-Photothermal Therapy of Tumors and Lung Metastases

Tumor combination therapy using nano formulations with multimodal synergistic therapeutic effects shows great potential for complete ablation of tumors. However, targeting tumor metastases with nano structures is a major obstacle for therapy. Therefore, developing a combination therapy system able to target both primary tumors and their metastases at distant sites with synergistic therapy is desirable for the complete eradication of tumors. To this end, a dual chemodrug-loaded theranostic system based on single walled carbon nanohorns (SWNHs) is developed for targeting both primary breast tumors and their lung metastases.

Methods: SWNHs were first modified simultaneously with poly (maleic anhydride-alt-1-octadecene) (C₁₈PMH) and methoxypolyethyleneglycol-b-poly-D, L-lactide (mPEG-PLA) via hydrophobic-hydrophobic interactions and π-π stacking. Then cisplatin and doxorubicin (DOX) (2.9:1 molar ratio) were sequentially loaded onto the modified nanohorns in a noninterfering way. After careful examinations of the release profiles of the loaded drugs and the photothermal performance of the dual chemodrug-loaded SWNHs, termed SWNHs/C₁₈PMH/mPEG-PLA-DOX-Pt, the dual drug chemotherapeutic and chemo-photothermal synergetic therapeutic effects on tumor cells were evaluated. Subsequently, the in vivo behavior and tumor accumulation of the drug-loaded SWNHs were studied by photoacoustic imaging (PAI). For chemo-photothermal therapy of tumors, 4T1 tumor bearing mice were intravenously injected with SWNHs/C₁₈PMH/mPEG-PLA-DOX-Pt at a dose of 10 mg/kg b.w. (in SWNHs) and tumors were illuminated by an 808 nm laser (1W/cm² for 5 min) 24 h post-injection.

Results: DOX and cisplatin were loaded onto the modified SWNHs with high efficiency (44 wt% and 66 wt%, respectively) and released in a pH-sensitive, tandem and sustainable manner. The SWNHs/C₁₈PMH/mPEG-PLA-DOX-Pt had a hydrodynamic diameter of 182 ± 3.2 nm, were highly stable in physiological environment, and had both dual drug chemotherapeutic (CI = 0.439) and chemo-photothermal synergistic antitumor effects (CI = 0.396) in vitro. Moreover, the dual drug-loaded SWNHs had a long blood half-life (10.9 h) and could address both the primary breast tumors and their lung metastases after intravenous administration. Consequently, chemo-photothermal combination therapy ablated the primary tumors and simultaneously eradicated the metastatic lung nodules.

Conclusion: Our study demonstrates that SWNHs/C₁₈PMH/mPEG-PLA-DOX-Pt is highly potent for chemo-photothermal combination therapy of primary tumors and cocktail chemotherapy of their metastases at a distant site.

Carbon Nano-Allotrope/Magnetic Nanoparticle Hybrid Nanomaterials as T2 Contrast Agents for Magnetic Resonance Imaging Applications

Magnetic resonance imaging (MRI) is the most powerful tool for deep penetration and high-quality 3D imaging of tissues with anatomical details. However, the sensitivity of the MRI technique is not as good as that of the radioactive or optical imaging methods. Carbon-based nanomaterials have attracted significant attention in biomaterial research in recent decades due to their unique physical properties, versatile functionalization chemistry, as well as excellent biological compatibility. Researchers have employed various carbon nano-allotropes to develop hybrid MRI contrast agents for improved sensitivity. This review summarizes the new research progresses in carbon-based hybrid MRI contrast agents, especially those reported in the past five years. The review will only focus on T2-weighted MRI agents and will be categorized by the different carbon allotrope types and magnetic components. Considering the strong trend in recent bio-nanotechnology research towards multifunctional diagnosis and therapy, carbon-based MRI contrast agents integrated with other imaging modalities or therapeutic functions are also covered.

Dopant-dependent crystallization and photothermal effect of Sb-doped SnO2 nanoparticles as stable theranostic nanoagents for tumor ablation

Ideal theranostic nanoagents should be "all-in-one" type nanocrystals that have a single-semiconductor component and all-required properties (such as imaging and photothermal effects), but most semiconductor nanocrystals do not have these required properties. With SnO₂ as a model of a typical wide-band semiconductor, we report the tuning from UV-responsive SnO₂ to blue SnO₂ nanocrystals with imaging ability and a Sb-doping-dependent photothermal effect. Sb-Doped SnO₂ nanocrystals were prepared by heating SbCl₃ and SnCl₄ in benzyl alcohol solution through a facile solvothermal route. When the SbCl₃/SnCl₄ molar ratio increases from 0 to 0.2/1, the obtained samples exhibit an increased photothermal effect under the irradiation of a 1064 nm laser, accompanied by gradually decreased size and crystallinity. With a further increase of the molar ratio from 0.3/1.0 to 1.0/1.0, the resulting samples demonstrate the tetragonal SnO₂ phase with amorphous-like compounds and they show no obvious enhancement of a photothermal effect. After a surface modification with biological molecules, the optimized Sb_0.2-SnO₂ nanocrystals demonstrated good stability and a high photothermal conversion efficiency of 48.3% as well as low cytotoxicity. When Sb_0.2-SnO₂ was injected into a tumor of mice, the tumor could be simultaneously detected by X-ray computed tomography (CT) and photoacoustic (PA) imaging, and then thermally ablated when exposed to a 1064 nm laser. Therefore, these nanocrystals can be used as "all-in-one" type nanoagents for imaging guided photothermal ablation of tumors under the irradiation of a laser in the second bio-transparent window.

A New Co-P Nanocomposite with Ultrahigh Relaxivity for In Vivo Magnetic Resonance Imaging-Guided Tumor Eradication by Chemo/Photothermal Synergistic Therapy

Design of new nanoagents that intrinsically have both diagnostic imaging and therapeutic capabilities is highly desirable for personalized medicine. In this work, a novel nanotheranostic agent is fabricated based on polydopamine (PDA)-functionalized Co-P nanocomposites (Co-P@PDA) for magnetic resonance imaging (MRI)-guided combined photothermal therapy and chemotherapy. The ultrahigh relaxivity of 224.61 mm^-1 s^-1 can enable Co-P@PDA to be applied as an excellent contrast agent for MRI in vitro and in vivo, providing essential and comprehensive information for tumor clinical diagnosis. Moreover, Co-P@PDA exhibit excellent photothermal performance owing to the strong near-infrared (NIR) absorbance of both Co-P nanocomposite and PDA. Highly effective ablation of tumors is achieved in a murine tumor model because the NIR laser not only induces photothermal effects but also triggers the chemotherapeutic drug on-demand release, which endows the Co-P@PDA with high curative effects but little toxicity and few side effects. These findings demonstrate that Co-P@PDA are promising agents for highly effective and precise antitumor treatment and warrant exploration as novel theranostic nanoagents with good potential for future clinical translation.

High-efficiency X-ray luminescence in Eu3+-activated tungstate nanoprobes for optical imaging through energy transfer sensitization

X-ray luminescence optical imaging has been recognized as a powerful technique for medical diagnosis due to its deep penetration and low auto-fluorescence in tissues. However, the low luminescence efficiency of current X-ray luminescence nanoprobes remains a major hurdle for sensitive bioimaging in practical medical applications. Here we present a new kind of energy transfer-sensitized X-ray luminescence nanoprobe (PEG-NaGd(WO₄)₂:Eu) for highly effective optical bioimaging. Under X-ray excitation, the tungstate host absorbs the X-ray photons and then transfers the energy to the Eu³⁺ luminescence center, thus enhancing the luminescence efficiency of the nanoprobes for high sensitivity optical in vivo imaging. Moreover, the shortened T₁ relaxation response of Gd³⁺ ions and X-ray attenuation capability of W atoms enable the nanoprobes to serve as efficient contrast agents for magnetic resonance imaging (MRI) and computed tomography (CT) imaging. Therefore, combined with the MRI, CT and X-ray luminescence imaging capabilities, the present PEG-NaGd(WO₄)₂:Eu nanoprobes could be used as promising multimodal imaging contrast agents in biological systems.

Polyacrylic Acid Functionalized Co0.85Se Nanoparticles: An Ultrasmall pH-Responsive Nanocarrier for Synergistic Photothermal-Chemo Treatment of Cancer

To surmount the challenges of limited drug penetration and therapeutic resistance in solid tumors, stimuli-responsive nanocarrier-based drug delivery systems (DDSs) with relatively small sizes are inherently favorable for combined treatment of cancerous cells. In this work, poly(acrylic acid) (PAA) functionalized Co_0.85Se nanoparticles (PAA-Co_0.85Se NPs) were synthesized through an ambient aqueous precipitating approach for synergistic photothermal-chemo treatment of cancer. The obtained PAA-Co_0.85Se NPs possess ultrasmall size (8.2 ± 2.6 nm), considerable near-infrared (NIR) light absorption, high photothermal transforming efficiency (45.2%) and low cytotoxicity, all of which are beneficial for localized photothermal ablation of cancer cells. Doxorubicin hydrochloride (DOX·HCl) was then successfully loaded on PAA-Co_0.85Se NPs with a loading capacity up to 8.3% to form PAA-Co_0.85Se-DOX composites, which exhibited an exciting acidic pH-responsive drug release property due to the protonation of amino groups in DOX and carboxyl groups in PAA molecules. As expected, when HeLa cells were treated with PAA-Co_0.85Se-DOX NPs as well as NIR laser irradiation, a significant synergistic cell-killing effect was observed, greatly improving the treatment efficiency. Thus, this work presents novel insight into the design of ultrasmall stimuli-responsive nanocarrier-based DDSs for synergistic photothermal-chemo treatment of cancer cells.

NIRF/PA/CT multi-modality imaging guided combined photothermal and photodynamic therapy based on tumor microenvironment-responsive nanocomposites

We developed a novel nanocomposite as a single nanoplatform (AlPc-MoS₂@SiO₂-CS) for photothermal and photodynamic therapy of tumors.

Metalla-aromatic loaded magnetic nanoparticles for MRI/photoacoustic imaging-guided cancer phototherapy

In this study, metalla-aromatic agents and a cluster of superparamagnetic iron oxide nanoparticles were loaded inside a micellar carrier and used for MRI/PA imaging-guided PTT/PDT synergistic cancer therapy.

Ambient Aqueous Synthesis of Ultrasmall Ni0.85Se Nanoparticles for Noninvasive Photoacoustic Imaging and Combined Photothermal-Chemotherapy of Cancer

Large-size-induced long-term retention in the body has hampered the translational applications of many reported nanomedicines. Herein, we reported a multifunctional theranostic agent composed of ultrasmall poly(acrylic acid)-functionalized Ni_0.85Se nanoparticles (PAA-Ni_0.85Se NPs), which were successfully obtained through a facile ambient aqueous precipitation strategy. Without exhibiting any noticeable toxicity, the as-prepared PAA-Ni_0.85Se NPs (average diameter of 6.40 ± 1.89 nm) showed considerable absorption in near-infrared (NIR) region and high photothermal conversion efficiency of 54.06%, which could induce remarkable photoacoustic signals for tumor imaging and heat for localized ablation of cancerous cells upon exposure to NIR light. Notably, the ultrasmall PAA-Ni_0.85Se NPs, unlike conventional nanomaterials with larger sizes, showed reasonable body clearance within 8 h after intravenous injection. Furthermore, ascribed to protonation process of amino groups in DOX molecules and carboxyl groups in PAA molecules in an acidic microenvironment, the drug-loaded (doxorubicin hydrochloride, DOX·HCl) PAA-Ni_0.85Se NPs (PAA-Ni_0.85Se-DOX NPs) revealed promoted drug release at acidic pH, which could be useful for acidic tumor microenvironment responsive drug delivery. Evident from the results of cell-killing assay in vitro and tumor treatment study in vivo, PAA-Ni_0.85Se-DOX NPs exhibited evident synergistic effects on killing 4T1 breast cancer cells. Thus, this study presents a multifunctional theranostic agent composed of ultrasmall PAA-Ni_0.85Se NPs for potential cancer treatment without long-term toxicity concerns.

Small Gold Nanorods: Recent Advances in Synthesis, Biological Imaging, and Cancer Therapy

Over the past few decades, the synthetic development of ultra-small nanoparticles has become an important strategy in nano-medicine, where smaller-sized nanoparticles are known to be more easily excreted from the body, greatly reducing the risk caused by introducing nano-theranostic agents. Gold nanorods are one of the most important nano-theranostic agents because of their special optical and electronic properties. However, the large size (diameter > 6 nm) of most obtained gold nanorods limits their clinical application. In recent years, more and more researchers have begun to investigate the synthesis and application of small gold nanorods (diameter < 6 nm), which exhibit similar optical and electronic properties as larger gold nanorods. In this review, we summarize the recent advances of synthesis of the small gold nanorods and their application for near-infrared light-mediated bio-imaging and cancer therapy.

Stable ICG-loaded upconversion nanoparticles: silica core/shell theranostic nanoplatform for dual-modal upconversion and photoacoustic imaging together with photothermal therapy

We report here the design and multiple functions of a new hierarchical nanotheronostic platform consisting of an upconversion nanoparticle (UCNP) core: shell with an additional mesoporous silica (mSiO2) matrix load shell containing sealed, high concentration of ICG molecules. We demonstrate that this UCNP@mSiO2-ICG nanoplatform can perform the following multiple functions under NIR excitation at 800 nm: 1) Light harvesting by the UCNP shell containing Nd and subsequent energy transfer to Er in the Core to produce efficient green and red upconversion luminescence for optical imaging; 2) Efficient nonradiative relaxation and local heating produced by concentration quenching in aggregated ICG imbedded in the mesopourous silica shell to enable both photoacoustic imaging and photothermal therapy. Compared to pure ICG, sealing of mesoporous silica platforms prevents the leak-out and improves the stability of ICG by protecting from rapid hydrolysis. Under 800 nm laser excitation, we performed both optical and photoacoustic (PA) imaging in vitro and in vivo. Our results demonstrated that UCNP@mSiO2-ICG with sealed structures could be systemically delivered to brain vessels, with a long circulation time. In addition, these nanoplatforms were capable of producing strong hyperthermia efforts to kill cancer cells and hela cells under 800 nm laser irradiation.

cis-Platinum pro-drug-attached CuFeS2 nanoplates for in vivo photothermal/photoacoustic imaging and chemotherapy/photothermal therapy of cancer

Photothermal therapy (PTT) has attracted considerable attention in cancer treatment. Herein, the facile synthesis of copper iron sulfide (chalcopyrite, CuFeS₂) nanoplates (NPs) with well-defined shape was achieved by a template-mediated method. Chitosan (CS), a linear cationic polysaccharide, was used to improve the physiological stability and biocompatibility. CuFeS₂ NPs with strong near-infrared (NIR) absorbance enabled contrasts in photothermal and photoacoustic (PA) imaging. In vitro and in vivo tumor ablation studies further demonstrated that CS-functionalized CuFeS₂ (CuFeS₂-CS) NPs could convert 808 nm NIR light into heat for PTT with a photothermal conversion efficiency up to 30.5%, which was clearly higher than that of CuS NPs (only 21.4%). Furthermore, CuFeS₂-CS NPs could also load cis-platinum pro-drug (CuFeS₂-CS-Pt), and CuFeS₂-CS-Pt showed a better synergistic therapeutic effect with respect to either chemotherapy or PTT.

Injectable thermosensitive magnetic nanoemulsion hydrogel for multimodal-imaging-guided accurate thermoablative cancer therapy

Ferrofluid-based magnetic hyperthermia of cancers has gained significant attention in recent years due to its excellent efficacy, few deleterious side effects and unlimited tissue penetration capacity. However, the high tumor osmotic pressure causes injection leakage and thus position imprecision because of the fluidity of the ferrofluid and the absence of multimodal imaging guidance, which create tremendous challenges for clinical application. Here, a body temperature-induced gelation strategy is constructed for accurate localized magnetic tumor regression based on the unique behaviors of a magnetic nanoemulsion hydrogel (MNH) within tumors. The rapid intra-tumor gelation can securely restrict the MNH in tumor tissue without diffusion and leakage. The magnetically induced nanoparticle assembly-enhanced heating in the hydrogel and the heat accumulation caused by crosslinking among the nanoemulsion droplets further increased the heating efficiency. Meanwhile, US/MR/NIR multimodal imaging can guide the whole therapeutic process, achieving excellent magnetic hyperthermia therapeutic efficiency. This work highlights the great promise for improving the magnetic hyperthermia efficiency and the precision of the injection site for localized tumor therapy.

Copper Manganese Sulfide Nanoplates: A New Two-Dimensional Theranostic Nanoplatform for MRI/MSOT Dual-Modal Imaging-Guided Photothermal Therapy in the Second Near-Infrared Window

Multifunctional nanoplatforms with integrated diagnostic and therapeutic functions have attracted tremendous attention. Especially, the second near-infrared (NIR-II) light response-based nanoplatforms hold great potential in cancer theranostic applications, which is because the NIR-II window provides larger tissue penetration depth and higher maximum permissible exposure (MPE) than that of the well-studied first near-infrared (NIR-I) window. Herein, we for the first time present a two-dimensional (2D)-nanoplatform based on Cu₂MnS₂ nanoplates (NPs) for magnetic resonance imaging (MRI)/multispectral optoacoustic tomography (MSOT) dual-modal imaging-guided photothermal therapy (PTT) of cancer in the NIR-II window. Methods: Cu₂MnS₂ NPs were synthesized through a facile and environmentally friendly process. A series of experiments, including the characterization of Cu₂MnS₂ NPs, the long-term toxicity of Cu₂MnS₂ NPs in BALB/c nude mice, the applications of Cu₂MnS₂ NPs for in vitro and in vivo MRI/MSOT dual-modal imaging and NIR-II PTT of cancer were carried out. Results: The as-synthesized Cu₂MnS₂ NPs exhibit low cytotoxicity, excellent biocompatibility as well as high photothermal conversion efficiency (~49.38%) and outstanding photostability. Together with their good T₁-shortening effect and strong absorbance in the NIR-I and NIR-II region, the Cu₂MnS₂ NPs display high-contrast imaging performance both in MRI and MSOT (900 nm laser source). Moreover, the subsequent in vitro and in vivo results demonstrate that the Cu₂MnS₂ NPs possess excellent PTT efficacy under 1064 nm laser irradiation with a low power density (0.6 W cm^-2). In addition, the detailed long-term toxicity studies further confirming the safety of Cu₂MnS₂ NPs in vivo. Conclusion: We have developed a new 2D Cu₂MnS₂ NPs as multifunctional theranostic agents for MRI/MSOT dual-modal imaging-guided PTT of cancer in the NIR-II window. Such biocompatible Cu₂MnS₂ NPs might provide a new perspective for exploring new 2D-based nanoplatforms with improved properties for clinical applications in the future.

Ultra-small pH-responsive Nd-doped NaDyF4 Nanoagents for Enhanced Cancer Theranostic by in situ Aggregation

To achieve accurate tumor location and highly efficient cancer therapy effect, the properties of cancer theranostic agents should be optimized and enhanced. In this work, ultra-small Nd doped NaDyF₄ were firstly reported as novel contrast agents for near-infrared second window downconversion luminescence (NIR II DCL) and magnetic resonance imaging. Based on the optimization strategy, gallic acid-Fe(III) complex modified NaDyF₄:10%Nd (NaDyF₄:10%Nd-GA-Fe) was selected as the optimal agent with high transversal relaxivity, strong NIR II DCL, high photothermal conversion efficiency, and low toxicity. In vitro experiment found that it can be aggregated rapidly in low pH condition, leading to the particle size increasing. Due to the theranostic properties coupled in NaDyF₄:10%Nd-GA-Fe are size dependent, properties enhancement was observed within the pH responsive aggregation progress. Further study in small animal model bearing tumor demonstrated the enhanced cancer theranostic by in situ aggregation. The optimized nanoagents have potential applications in medical and also provide a novel strategy for future study of cancer theranostic enhancement.

Bioinspired "Active" Stealth Magneto-Nanomicelles for Theranostics Combining Efficient MRI and Enhanced Drug Delivery

The mononuclear phagocyte system (MPS) with key roles in recognition and clearance of foreign particles, is a major constraint to nanoparticle-based delivery systems. The desire to improve the delivery efficiency has prompted the search for stealthy long-circulating nanoplatforms. Herein, we design an antiphagocytic delivery system with "active" stealth behavior for cancer theranostics combining efficient MRI and enhanced drug delivery. We modify self-peptide, a synthetic peptide for active immunomodulation, to biodegradable poly(lactide-glycolide)-poly(ethylene glycol) (PLGA-PEG), then utilize the self-assembly properties of PLGA-PEG to form nanomicelles that encapsulating iron oxide (IO) nanoparticles and anticancer drug paclitaxel (PTX). Through the interaction of self-peptide with the receptor SIRPα, which is expressed on phagocytes, the as-prepared nanomicelles can disguise as "self" to avoid being recognized as foreign particles by MPS, leading to improved blood circulation time and delivery efficiency. Compared to the "passive" stealth effect generating by PEG or zwitterionic polymers that only passively delay the physisorption of serum proteins to nanocarriers, the "active self" nanomicelles can more efficiently inhibit the MPS-mediated immune clearance and reduce "accelerated blood clearance" phenomenon. Furthermore, this one-step clustering of IO nanoparticles and loading of PTX endow the resulted magneto-nanomicelles with enhanced T₂ MRI contrast performance and antitumor effect. We believe that this study provides a novel approach in designing of efficient stealth antiphagocytic delivery systems that resisting the MPS-mediated clearance for cancer theranostics.

Amphiphilic semiconducting polymer as multifunctional nanocarrier for fluorescence/photoacoustic imaging guided chemo-photothermal therapy

Chemo-photothermal nanotheranostics has the advantage of synergistic therapeutic effect, providing opportunities for optimized cancer therapy. However, current chemo-photothermal nanotheranostic systems generally comprise more than three components, encountering the potential issues of unstable nanostructures and unexpected conflicts in optical and biophysical properties among different components. We herein synthesize an amphiphilic semiconducting polymer (PEG-PCB) and utilize it as a multifunctional nanocarrier to simplify chemo-photothermal nanotheranostics. PEG-PCB has a semiconducting backbone that not only serves as the diagnostic component for near-infrared (NIR) fluorescence and photoacoustic (PA) imaging, but also acts as the therapeutic agent for photothermal therapy. In addition, the hydrophobic backbone of PEG-PCB provides strong hydrophobic and π-π interactions with the aromatic anticancer drug such as doxorubicin for drug encapsulation and delivery. Such a trifunctionality of PEG-PCB eventually results in a greatly simplified nanotheranostic system with only two components but multimodal imaging and therapeutic capacities, permitting effective NIR fluorescence/PA imaging guided chemo-photothermal therapy of cancer in living mice. Our study thus provides a molecular engineering approach to integrate essential properties into one polymer for multimodal nanotheranostics.

Photothermal Effect Enhanced Cascade-Targeting Strategy for Improved Pancreatic Cancer Therapy by Gold Nanoshell@Mesoporous Silica Nanorod

Pancreatic cancer, one of the leading causes of cancer-related mortality, is characterized by desmoplasia and hypovascular cancerous tissue, with a 5 year survival rate of <8%. To overcome the severe resistance of pancreatic cancer to conventional therapies, we synthesized gold nanoshell-coated rod-like mesoporous silica (GNRS) nanoparticles which integrated cascade tumor targeting (mediated by photothermal effect and molecular receptor binding) and photothermal treatment-enhanced gemcitabine chemotherapy, under mild near-infrared laser irradiation condition. GNRS significantly improved gemcitabine penetration and accumulation in tumor tissues, thus destroying the dense stroma barrier of pancreatic cancer and reinforcing chemosensitivity in mice. Our current findings strongly support the notion that further development of this integrated plasmonic photothermal strategy may represent a promising translational nanoformulation for effective treatment of pancreatic cancer with integral cascade tumor targeting strategy and enhanced drug delivery efficacy.

Degradable Hollow Mesoporous Silicon/Carbon Nanoparticles for Photoacoustic Imaging-Guided Highly Effective Chemo-Thermal Tumor Therapy in Vitro and in Vivo

The development of nanoscaled theranostic agents for cancer combination therapies has received intensive attention in recent years. In this report, a degradable hollow mesoporous PEG-Si/C-DOX NP is designed and fabricated for pH-responsive, photoacoustic imaging-guided highly effective chemo-thermal combination therapy. The intrinsic hollow mesoporous structure endows the as-synthesized nanoparticles (NPs) with a high drug loading capacity (31.1%). Under NIR (808 nm) irradiation, the photothermal conversion efficiency of the Si/C NPs is as high as 40.7%. Preferential accumulation of the PEG-Si/C-DOX NPs around tumor tissue was demonstrated with photoacoustic images. Cellular internalization of the NPs and release of the DOX in nuclei are shown with fluorescent images. With efficient NIR photothermal conversion and high DOX loading capacity, the PEG-Si/C-DOX NPs are demonstrated to have remarkable cancer-cell-killing ability and to achieve complete in vivo tumor elimination via combinational chemo-thermal therapy. Last but not least, the NPs show good biodegradability and biosafety, making them a promising candidate for multifunctional drug delivery and cancer theranostic.

A54 peptide-mediated functionalized gold nanocages for targeted delivery of DOX as a combinational photothermal-chemotherapy for liver cancer

The combination of photothermal therapy and chemotherapy (photothermal–chemotherapy) is a promising strategy for cancer therapy. Gold nanocages (AuNCs), with hollow and porous structures and unique optical properties, have become a rising star in the field of drug delivery. Here, we designed a novel targeted drug delivery system based on functionalized AuNCs and evaluated their therapeutic effects in vitro and in vivo. We then loaded doxorubicin into this promising system, designated as DHTPAuNCs consisting of hyaluronic acid-grafted and A54 peptide-targeted PEGylated AuNCs. Its formation was corroborated by ultraviolet–visible spectroscopy, transmission electron microscopy and dynamic light scattering. This delivery platform needed hyaluronidase to release encapsulated drugs, meanwhile the acidic pH and near-infrared irradiation could accelerate the release. In addition, the results of cellular uptake demonstrate that this system could bind specifically with BEL-7402 cells. In vitro, we evaluated therapeutic effects of the DHTPAuNCs in BEL-7402 cells by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide assay. Moreover, in BEL-7402 tumor-bearing nude mice, its therapy effect in vivo was also evaluated. As expected, DHTPAuNCs exhibited excellent therapeutic effect by photothermal–chemotherapy, both in vitro and in vivo. In short, DHTPAuNCs with low toxicity showed great potential as a drug delivery system for cancer therapy.

Tumor microenvironment-triggered fabrication of gold nanomachines for tumor-specific photoacoustic imaging and photothermal therapy

Nanoparticles as novel theranostic agents for cancer treatment have been extensively investigated in recent years. However, the poor tumor selectivity and retention of the theranostic agents result in unsatisfactory performance of both the diagnostic and therapeutic functions. Herein, we developed an alpha-cyclodextrin (α-CD)-based gold/DNA nanomachine for tumor-selective diagnosis and therapy. The α-CDs were capped at the ends of DNA, and their release was triggered by the low pH of the tumor microenvironment, which further resulted in DNA self-assembly through complementary base pairing. The large-sized gold aggregates failed to escape from the tumor tissue, thereby realizing the goal of tumor-specific targeting and enhanced retention. Thus, the photoacoustic signal and photothermal effect are also activated, thereby achieving tumor-targeted photoacoustic imaging and photothermal therapy. In vivo results indicated that the designed gold nanomachines can serve as efficient theranostic agents for diagnosis and therapy. Moreover, we found that the α-CD caps have the ability to protect the nanoparticles from clearance and enzyme digestion, which helps the nanoparticles reach the tumor more efficiently.

Biocompatible PEGylated bismuth nanocrystals: "All-in-one" theranostic agent with triple-modal imaging and efficient in vivo photothermal ablation of tumors

Biocompatible single-component theranostic agents integrating multimodal imaging and therapeutic functions (namely, "all-in one" agents) are highly desired for clinical cancer treatments. Herein, PEGylated pure metallic bismuth nanocrystals (Bi-PEG NCs) have been developed to be a competent theranostic agent for in vivo high-performance multimodal bio-imaging and photothermal ablation of tumors. The resultant Bi-PEG NCs show excellent physiological stability, biocompatibility, prolonged blood circulation half-life and preferential tumor accumulation. Thanking to the strong near-infrared (NIR) absorbance as well as the high photothermal conversion efficiency and conversion stability, highly effective in vivo photothermal ablation on tumors has been realized upon NIR irradiation, without noticeable toxicity. Impressively, the Bi-PEG NCs show ultrahigh X-ray computed topography (CT) enhancement efficiency (∼60.3 HU mL mg^-1), overwhelming all CT contrast agents reported so far. Combining the strong CT contrast ability and photoacoustic/photothermal effect, high-contrast CT, photoacoustic (PA) and infrared thermal (IRT) triple-modal imaging have been demonstrated both in vitro and in vivo. This work highlights the potentials of such NCs as a powerful "all-in-one" theranostic nanoplatform for bioimaging and antitumor therapy, and may have provided a rather promising candidate for clinically-applied antitumor treatments based on single-component agents.

Photoacoustic Drug Delivery

Photoacoustic (PA) technology holds great potential in clinical translation as a new non-invasive bioimaging modality. In contrast to conventional optical imaging, PA imaging (PAI) enables higher resolution imaging with deeper imaging depth. Besides applications for diagnosis, PA has also been extended to theranostic applications. The guidance of PAI facilitates remotely controlled drug delivery. This review focuses on the recent development of PAI-mediated drug delivery systems. We provide an overview of the design of different PAI agents for drug delivery. The challenges and further opportunities regarding PA therapy are also discussed.