Emerging Strategies of Nanomaterial-Mediated Tumor Radiosensitization

Full-Process Radiosensitization Based on Nanoscale Metal-Organic Frameworks

Full-process radiosensitization, that is, pre-increasing radiation sensitivity of cancer cells, magnifying •OH formation during ionizing irradiation, and intervention on the resultant DNA repair for final cells death, could enhance the overall radiotherapeutic effects, but has not yet been achieved. Herein, Hf-nMOFs with Fe³⁺ ions uniformly dispersed (Hf-BPY-Fe) were constructed to integratedly improve radiotherapeutic effects via a multifaceted mechanism. The in vitro experiments demonstrated that persistent reactive oxygen species stress from Hf-BPY-Fe-activated in situ Fenton reaction reassorted cell cycle distribution, consequently contributing to increased tumoral radiosensitivity to photon radiation. Upon irradiation during the course of radiation therapy, Hf⁴⁺ in Hf-BPY-Fe gave substantial amounts of high-energy electrons, which partially converted H₂O to •OH and, meanwhile, relaxed to a low-energy state in nMOF pores, leading to an electron-rich environment. These aggregated electrons facilitated the reduction from Fe³⁺ to Fe²⁺ and further promoted the production of •OH in the Fenton process to attack DNA. The Hf-BPY-Fe postponed the DNA damage response process by interfering with certain proteins involved in the DNA repair signaling pathway. The in vivo experiments showed improved radiotherapeutic effects from integrated contributions from Fe³⁺-based Fenton reaction and Hf⁴⁺-induced X-ray energy conversion in tumors. This work provides a nMOFs-based full-process radiosensitizing approach for better radiotherapeutic efficacy.

The Rational Design and Biological Mechanisms of Nanoradiosensitizers

Radiotherapy (RT) has been widely used for cancer treatment. However, the intrinsic drawbacks of RT, such as radiotoxicity in normal tissues and tumor radioresistance, promoted the development of radiosensitizers. To date, various kinds of nanoparticles have been found to act as radiosensitizers in cancer radiotherapy. This review focuses on the current state of nanoradiosensitizers, especially the related biological mechanisms, and the key design strategies for generating nanoradiosensitizers. The regulation of oxidative stress, DNA damage, the cell cycle, autophagy and apoptosis by nanoradiosensitizers in vitro and in vivo is highlighted, which may guide the rational design of therapeutics for tumor radiosensitization.

Ultrasmall BiOI Quantum Dots with Efficient Renal Clearance for Enhanced Radiotherapy of Cancer

Emerging strategies involving nanomaterials with high-atomic-number elements have been widely developed for radiotherapy in recent years. However, the concern regarding their potential toxicity caused by long-term body retention still limits their further application. In this regard, rapidly clearable radiosensitizers are highly desired for practical cancer treatment. Thus, in this work, ultrasmall BiOI quantum dots (QDs) with efficient renal clearance characteristic and strong permeability inside solid tumor are designed to address this issue. Additionally, considering that injection methods have great influence on the biodistribution and radiotherapeutic efficacy of radiosensitizers, two common injection methods including intratumoral injection and intravenous injection are evaluated. The results exhibit that intratumoral injection can maximize the accumulation of radiosensitizers within a tumor compared to intravenous injection and further enhance radiotherapeutic efficacy. Furthermore, the radiosensitizing effect of BiOI QDs is revealed, which is not only attributed to the radiation enhancement of high-Z elements but also is owed to the •OH production via catalyzing overexpressed H2O2 within a tumor by BiOI QDs under X-ray irradiation. As a result, this work proposes a treatment paradigm to employ ultrasmall radiosensitizers integrated with local intratumoral injection to realize rapid clearance and high-efficiency radiosensitization for cancer therapy.

Emerging Prospects for Nanoparticle-Enabled Cancer Immunotherapy

One of the standards for cancer treatment is cancer immunotherapy which treats both primary and metastasized tumors. Although cancer immunotherapeutics show better outcomes as compared with conventional approaches of cancer treatment, the currently used cancer immunotherapeutics have limited application in delivering cancer antigens to immune cells. Conversely, in solid tumors, tumor microenvironment suppresses the immune system leading to the evasion of anticancer immunity. Some promising attempts have been made to overcome these drawbacks by using different approaches, for instance, the use of biomaterial-based nanoparticles. Accordingly, various studies involving the application of nanoparticles in cancer immunotherapy have been discussed in this review article. This review not only describes the modes of cancer immunotherapy to reveal the importance of nanoparticles in this modality but also narrates nanoparticle-mediated delivery of cancer antigens and therapeutic supplements. Moreover, the impact of nanoparticles on the immunosuppressive behavior of tumor environment has been discussed. The last part of this review deals with cancer immunotherapy using a combination of traditional interventional oncology approach and image-guided local immunotherapy against cancer. According to recent studies, cancer therapy can potentially be improved through nanoparticle-based immunotherapy. In addition, drawbacks associated with the currently used cancer immunotherapeutics can be fixed by using nanoparticles.

Organelle-localized radiosensitizers

This feature article highlights the recent advances of organelle-localized radiosensitizers and discusses the current challenges and future directions.

Smart H2S-Triggered/Therapeutic System (SHTS)-Based Nanomedicine

Hydrogen sulfide (H2S) is of vital importance in several biological and physical processes. The significance of H2S-specific detection and monitoring is emphasized by its elevated levels in various diseases such as cancer. Nanotechnology enhances the performance of chemical sensing nanoprobes due to the enhanced efficiency and sensitivity. Recently, extensive research efforts have been dedicated to developing novel smart H2S-triggered/therapeutic system (SHTS) nanoplatforms for H2S-activated sensing, imaging, and therapy. Herein, the latest SHTS-based nanomaterials are summarized and discussed in detail. In addition, therapeutic strategies mediated by endogenous H2S as a trigger or exogenous H2S delivery are also included. A comprehensive understanding of the current status of SHTS-based strategies will greatly facilitate innovation in this field. Lastly, the challenges and key issues related to the design and development of SHTS-based nanomaterials (e.g., morphology, surface modification, therapeutic strategies, appropriate application, and selection of nanomaterials) are outlined.

Radiosensitive core/satellite ternary heteronanostructure for multimodal imaging-guided synergistic cancer radiotherapy

Developing safe, effective and targeting radiosensitizers with clear action mechanisms to achieve synergistic localized cancer treatment is an important strategy for radiotherapy. Herein, we design and synthesize a ternary heteronanostructure radiosensitizer (SeAuFe-EpC) with core/satellite morphology by a simple method to realize multimodal imaging-guided cancer radiotherapy. The mechanistic studies reveal that Se incorporation could drastically improve the electrical conductivity and lower the energy barrier between the three components, resulting in more electrons transfer between Se-Au interface and migration over the heterogeneous junction of Au-Fe₃O₄ NPs interface. This synergistic interaction enhanced the energy transfer and facilitated more excited excitons generated by SeAuFe-EpC NPs, thus promoting the transformation of ³O₂ to ¹O₂via resonance energy transfer, finally resulting in irreversible cancer cell apoptosis. Additionally, based on the X-ray attenuation ability and high NIR absorption of AuNPs and the superparamagnetism of Fe₃O₄, in vivo computer tomography, photoacoustic and magnetic resonance tri-modal imaging have been employed to visualize the tracking and targeting ability of the NPs. As expected, the NPs specifically accumulated in orthotopic breast tumor area and achieved synergistic anticancer efficacy, but showed no toxic side effects on main organs. Collectively, this study sheds light on the potential roles of core/satellite heteronanostructure in imaging-guided cancer radiotherapy.

Codoping Enhanced Radioluminescence of Nanoscintillators for X-ray-Activated Synergistic Cancer Therapy and Prognosis Using Metabolomics

Radio- and photodynamic therapies are the first line of cancer treatments but suffer from poor light penetration and less radiation accumulation in soft tissues with high radiation toxicity. Therefore, a multifunctional nanoplatform with diagnosis-assisted synergistic radio- and photodynamic therapy and tools facilitating early prognosis are urgently needed to fight the war against cancer. Further, integrating cancer therapy with untargeted metabolomic analysis would collectively offer clinical pertinence through facilitating early diagnosis and prognosis. Here, we enriched scintillation of CeF₃ nanoparticles (NPs) through codoping Tb³⁺ and Gd³⁺ (CeF₃:Gd³⁺,Tb³⁺) for viable clinical approach in the treatment of deep-seated tumors. The codoped CeF₃:Gd³⁺,Tb³⁺ scintillating theranostic NPs were then coated with mesoporous silica, followed by loading with rose bengal (CGTS-RB) for later computed tomography (CT)- and magnetic resonance image (MRI)-guided X-ray stimulated synergistic radio- and photodynamic therapy (RT+XPDT) using low-dose, one-time X-ray irradiation. The results corroborated an efficient tumor regression with synergistic RT+XPDT relative to single RT. Global untargeted metabolome shifts highlighted the mechanism behind this efficient tumor regression using RT, and synergistic RT+XPDT treatment is due to the starvation of nonessential amino acids involved in protein and DNA synthesis and energy regulation pathways necessary for growth and progression. Our study also concluded that tumor and serum metabolites shift during disease progression and regression and serve as robust biomarkers for early assessment of disease state and prognosis. From our results, we propose that codoping is an effective and extendable technique to other materials for gaining high optical yield and multifunctionality and for use in diagnostic and therapeutic applications. Critically, the integration of multifunctional theranostic nanomedicines with metabolomics has excellent potential for the discovery of early metabolic biomarkers to aid in better clinical disease diagnosis and prognosis.

Tumor Targeted Albumin Coated Bismuth Sulfide Nanoparticles (Bi2S3) as Radiosensitizers and Carriers of Curcumin for Enhanced Chemoradiation Therapy

Combination therapy such as radiotherapy combined with chemotherapy has attracted excessive interest in the new cancer research area. Therefore, developing nanobiomaterials for combination of radiotherapy and chemotherapy is required for more powerful and successful cures. Because of the amazing X-ray sensitization proficiency of Bi based nanoparticles, in this work, we synthesized and used Bi₂S₃ as an enhancer of X-ray radiation therapy, and furthermore, Bi₂S₃ served as carrier of curcumin (CUR), a chemotherapy drug, for the goal of combination therapy. Additionally, we selected and conjugated folic acid (FA) as a targeting molecule for the direction of the designed system to the tumor site. After characterization of drug loaded FA conjugated Bi₂S₃@BSA nanoparticles (Bi₂S₃@BSA-FA-CUR) and in vitro and in vivo safety assessment, we applied it for enhanced chemotherapy and X-ray radiation therapy in cancer cells and a tumor bearing mice model. Moreover, the CT contrast ability of synthesized nanoparticles was examined. Here, we (1) for the first time developed the novel and targeted CUR loaded Bi₂S₃@BSA (Bi₂S₃@BSA-FA-CUR) to promote chemoradiation therapy in 4T1 cells and breast tumor in mice; (2) found the synthesized nanoparticles to have good stability; (3) injected a single dose of the designed radiosensitizer for cancer therapy; and (4) used a conventional X-ray dose, 2Gy, for X-ray radiation therapy. The result of in vivo X-ray radiotherapy shows that the mice tumors vanished near 3 weeks after radiation. Interestingly, these results show that Bi₂S₃@BSA-FA-CUR with the aid of X-ray can clearly promote the efficacy of chemoradiation therapy.

Strategies based on metal-based nanoparticles for hypoxic-tumor radiotherapy

Radiotherapy (RT) is one of the most effective and frequent clinical cancer treatments. Nevertheless, RT can cause damage to normal tissues around tumors under high-dose ionizing radiation. Inspired by versatile metal-based nanomaterials, great efforts have been devoted to developing nanomaterials with high-Z metal elements as radiosensitizers by depositing more energy into tumors for RT enhancement. However, these metal-based nanomaterial-mediated RTs are highly O2-dependent. Unfortunately, O2 concentrations within the majority of solid tumors exhibit low levels, which seriously hampers the antitumor efficacy of these nanomaterials during RT. Therefore, the development of novel metal-based nanomaterials as radiosensitizers capable of avoiding the radioresistance induced by tumor hypoxia is highly desirable and important. Currently, the most effective approaches to reverse the radioresistance of hypoxic tumors are to introduce nanomaterials with O2-elevating ability by delivering exogenous O2, generating O2 in situ, increasing intratumoral blood flow, or reducing HIF-1 expression to harness the O2 level in solid tumors. Besides these, recently, some innovative and simple strategies by employing nanoradiosensitizers with diminished oxygen dependence have also been applied to combat unmet hypoxic challenges, in which nanoradiosensitizers can target tumor hypoxia for selective RT, enhance oxygen-independent ROS generation, or combine with non-oxygen dependent cancer therapies for synergistic treatments. These approaches and strategies provide new avenues for enhanced hypoxic-tumor RT. Nevertheless, an overall review aiming specifically at these strategies is still rare. Herein, we present an overview about recent advances in metal-based nanomaterials for hypoxic-tumor RT, and give a detailed discussion about the design and working mechanisms of these strategies in their application of RT. Finally, current challenges and future perspectives are also pointed out in this field.

Tumor Microenvironment-Responsive Nanoshuttles with Sodium Citrate Modification for Hierarchical Targeting and Improved Tumor Theranostics

Enhancement of permeability and the retention effect is one of the main pathways for the accumulation of nanomaterials in tumor sites, but poor cellular internalization and rapid clearance of nanomaterials always hamper the efficacy of imaging diagnosis and treatment. With the consideration of both high tumor accumulation and cellular internalization, positively charged nanomaterials can adhere to the tumor cell membrane by an electrostatic force, which is conducive to cellular internalization, but they are easily recognized and cleared during blood circulation. However, negatively charged nanomaterials show an enhanced stealth-like effect and possess a long blood circulation time, which is conducive to tumor accumulation. Therefore, in this work, on the basis of the shielding effect of citrate ions to positive charge and the protonation under an acidic tumor microenvironment, pH-sensitive sodium citrate-modified polyaniline nanoshuttles (NSs) with negative charge during blood circulation but positive charge in tumor sites are designed. With this hierarchical targeting strategy, the blood circulation half-life increases from 4.35 to 7.33 h, and the retention rate of NSs in tumors increases from 5.29 to 8.57% ID/g. Because the retention rate of NSs is increased, the magnetic resonance imaging resolution and signal intensity are significantly improved. A synergistic treatment of tumors is further achieved by means of photothermal therapy with laser irradiation and chemotherapy via heat-stimulated drug release.

Bi2WO6 Semiconductor Nanoplates for Tumor Radiosensitization through High- Z Effects and Radiocatalysis

The radioresistance of tumor cells is considered to be an Achilles' heel of cancer radiotherapy. Thus, an effective and biosafe radiosensitizer is highly desired but hitherto remains a big challenge. With the rapid progress of nanomedicine, multifunctional inorganic nanoradiosensitizers offer a new route to overcome the radioresistance and enhance the efficacy of radiotherapy. Herein, poly(vinylpyrrolidone) (PVP)-modified Bi₂WO₆ nanoplates with good biocompatibility were synthesized through a simple hydrothermal process and applied as a radiosensitizer for the enhancement of radiotherapy for the first time. On the one hand, the high- Z elements Bi ( Z = 83) and W ( Z = 74) endow PVP-Bi₂WO₆ with better X-ray energy deposition performance and thus enhance radiation-induced DNA damages. On the other hand, Bi₂WO₆ semiconductors exhibit significant photocurrent and photocatalytic-like radiocatalytic activity under X-ray irradiation, giving rise to the effective separation of electron/hole (e^-/h⁺) pairs and subsequently promoting the generation of cytotoxic reactive oxygen species, especially hydroxyl radicals (^•OH). The γ-H2AX and clonogenic assays demonstrated that PVP-Bi₂WO₆ could efficiently increase cellular DNA damages and colony formations under X-ray irradiation. These versatile features endowed PVP-Bi₂WO₆ nanoplates with enhanced radiotherapy efficacy in animal models. In addition, Bi₂WO₆ nanoplates can also serve as good X-ray computed tomography imaging contrast agents. Our findings provide an alternative nanotechnology strategy for tumor radiosensitization through simultaneous radiation energy deposition and radiocatalysis.

Enhanced Generation of Non-Oxygen Dependent Free Radicals by Schottky-type Heterostructures of Au-Bi2S3 Nanoparticles via X-ray-Induced Catalytic Reaction for Radiosensitization

Despite the development of nanomaterials with high-Z elements for radiosensitizers, most of them suffer from their oxygen-dependent behavior in hypoxic tumor, nonideal selectivity to tumor, or inevasible damages to normal tissue, greatly limiting their further applications. Herein, we develop a Schottky-type heterostructure of Au-Bi₂S₃ with promising ability of reactive free radicals generation under X-ray irradiation for selectively enhancing radiotherapeutic efficacy by catalyzing intracellular H₂O₂ in tumor. On the one hand, like many other nanomaterials with rich high-Z elements, Au-Bi₂S₃ can deposit higher radiation dose within tumors in the form of high energy electrons. On the other hand, Au-Bi₂S₃ can remarkably improve the utilization of a large number of X-ray-induced low energy electrons during radiotherapy for nonoxygen dependent free radicals generation even in hypoxic condition. This feature of Schottky-type heterostructures Au-Bi₂S₃ attributes to the generated Schottky barrier between metal Au and semiconductor Bi₂S₃, which can trap the X-ray-generated electrons and transfer them to Au, resulting in efficient separation of the electron-hole pairs. Then, because of the matched potential between the conduction band of Bi₂S₃ and overexpressed H₂O₂ within tumor, the Au-Bi₂S₃ HNSCs can decompose the intracellular H₂O₂ into highly toxic ^•OH for selective radiosensitization in tumor. As a consequence, this kind of nanoparticle provides an idea to develop rational designed Schottky-type heterostructures as efficient radiosensitizers for enhanced radiotherapy of cancer.

Two-dimensional molecular brush-functionalized porous bilayer composite separators toward ultrastable high-current density lithium metal anodes

Lithium metal batteries have been considerably limited by the problems of uncontrolled dendritic lithium formation and the highly reactive nature of lithium with electrolytes. Herein, we have developed functional porous bilayer composite separators by simply blade-coating polyacrylamide-grafted graphene oxide molecular brushes onto commercial polypropylene separators. Our functional porous bilayer composite separators integrate the lithiophilic feature of hairy polyacrylamide chains and fast electrolyte diffusion pathways with the excellent mechanical strength of graphene oxide nanosheets and thus enable molecular-level homogeneous and fast lithium ionic flux on the surfaces of electrodes. As a result, dendrite-free uniform lithium deposition with a high Coulombic efficiency (98%) and ultralong-term reversible lithium plating/stripping (over 2600 h) at a high current density (2 mA cm-2) are achieved for lithium metal anodes. Remarkably, lithium metal anodes with an unprecedented stability of more than 1900 h cycling at an ultrahigh current density of 20 mA cm-2 are demonstrated.

Energy-Converting Nanomedicine

Serious side effects to surrounding normal tissues and unsatisfactory therapeutic efficacy hamper the further clinic applications of conventional cancer-therapeutic strategies, such as chemotherapy and surgery. The fast development of nanotechnology provides unprecedented superiorities for cancer therapeutics. Externally activatable therapeutic modalities mediated by nanomaterials, relying on highly effective energy transformation to release therapeutic elements/effects (cytotoxic reactive oxygen species, thermal effect, photoelectric effect, Compton effect, cavitation effect, mechanical effect or chemotherapeutic drug) for cancer therapies, categorized and termed as "energy-converting nanomedicine," have arouse considerable concern due to their noninvasiveness, desirable tissue-penetration depth, and accurate modulation of therapeutic dose. This review summarizes the recent advances in the engineering of intelligent functional nanotherapeutics for energy-converting nanomedicine, including photo-based, radiation-based, ultrasound-based, magnetic field-based, microwave-based, electric field-based, and radiofrequency-based nanomedicines, which are enabled by external stimuli (light, radiation, ultrasound, magnetic field, microwave, electric field, and radiofrequency). Furthermore, biosafety issues of energy-converting nanomedicine related to future clinical translation are also addressed. Finally, the potential challenges and prospects of energy-converting nanomedicine for future clinical translation are discussed.