Polysaccharide-Based Stimulus-Responsive Nanomedicines for Combination Cancer Immunotherapy

Konjac glucomannan exerts regulatory effects on macrophages and its applications in biomedical engineering

Konjac glucomannan (KGM) molecular chains contain a small amount of acetyl groups and a large number of hydroxyl groups, thereby exhibiting exceptional water retention and gel-forming properties. To meet diverse requirements, KGM undergoes modification processes such as oxidation, acetylation, grafting, and cationization, which reduce its viscosity, enhance its mechanical strength, and improve its water solubility. Researchers have found that KGM and its derivatives can regulate the polarization of macrophages, inducing their transformation into classically activated M1-type macrophages or alternatively activated M2-type macrophages, and even facilitating the interconversion between M1 and M2 phenotypes. Concurrently, the modulation of macrophage polarization states holds significant importance for chronic wound healing, inflammatory bowel disease (IBD), antitumor therapy, tissue engineering scaffolds, oral vaccines, pulmonary delivery, and probiotics. Therefore, KGM has the advantages of both immunomodulatory effects (biological activity) and gel-forming properties (physicochemical properties), giving it significant advantages in a variety of biomedical engineering applications.

Delivery of natural products via polysaccharide-based nanocarriers for cancer therapy: A review on recent advances and future challenges

Cancer, caused by uncontrolled proliferation of abnormal cells, has long been a global public health issue. For decades, natural products have been proven to be an essential source for novel anticancer drug discovery. But their instability, low solubility and bioavailability, poor targeting impede therapeutic efficacy. With the development of nanotechnology, nanomedicine delivery systems have emerged as promising strategies to improve bioavailability and enhance the therapeutic efficacy of drugs. However, constructing suitable nanocarrier is still a major challenge. Polysaccharides are extensively employed as carrier materials in nanomedicine delivery systems, owing to their unique physicochemical properties, biocompatibility and low immunogenicity. Polysaccharide-based nanomedicine delivery systems show high drug delivery efficiency, controlled drug release, and precise tumor targeting. This paper reviews influencing factors in the construction of polysaccharide-based nanocarriers and the application of polysaccharide-based nanocarriers for the delivery of natural products in treating various cancers. It focuses on their in vitro and in vivo anticancer efficacy and mechanisms. Furthermore, the review contrasts the capabilities and limitations of polysaccharide-based nanocarriers with traditional delivery methods, underlining their potential to enable targeted, reduced toxicity and excellent cancer treatment modalities. Finally, we discuss the current research limitations and future prospects in this emerging field.

Recent advances on chitosan/hyaluronic acid-based stimuli-responsive hydrogels and composites for cancer treatment: A comprehensive review

Cancer, as leading cause of death, has a high rate of mortality worldwide. Although there is a wide variety of conventional approaches for the treatment of cancer (such as surgery and chemotherapy), they have considerable drawbacks in terms of practicality, treatment efficiency, and cost-effectiveness. Therefore, there is a fundamental requirement for the development of safe and efficient treatment modalities based on breakthrough technologies to suppress cancer. Chitosan (CS) and hyaluronic acid (HA) polysaccharides, as FDA-approved biomaterials for some biomedical applications, are potential biopolymers for the efficient treatment of cancer. CS and HA have high biocompatibility, bioavailability, biodegradability, and immunomodulatory function which guarantee their safety and non-toxicity. CS-/HA-based hydrogels (HGs)/composites stand out for their potential anticancer function, versatile preparation and modification, ease of administration, controlled/sustained drug release, and active and passive drug internalization into target cells which is crucial for efficient treatment of cancer compared with conventional treatment approaches. These HGs/composites can respond to external (magnetic, ultrasound, light, and thermal) and internal (pH, enzyme, redox, and ROS) stimuli as well which further paves the way to their manipulation, targeted drug delivery, practicality, and efficient treatment. The above-mentioned properties of CS-/HA-based HGs/composites are unique and practical in cancer treatment which can ignore the deficiencies of conventional approaches. The present manuscript comprehensively highlights the advances in the practical application of stimuli-responsive HGs/composites based on CS/HA polysaccharides.

DNA nanodevice as a multi-module co-delivery platform for combination cancer immunotherapy

A major challenge in combining cancer immunotherapy is the efficient delivery of multiple types of immunological stimulators to elicit a robust anti-tumor immune response and reprogram the immunosuppressive tumor microenvironment (TME). Here, we developed a DNA nanodevice that was generated by precisely assembling three types of immunological stimulators. The doxorubicin (Dox) component induced immunogenic cell death (ICD) in tumor cells and enhanced phagocytosis of antigen-presenting cells (APCs). Exogenous double-stranded DNA (dsDNA) could act as a molecular adjuvant to activate the stimulator of interferon genes (STING) signaling in APCs by engulfing dying tumor cells. Interleukin (IL)-12 and small hairpin programmed cell death-ligand 1 (shPD-L1) transcription templates were designed to regulate TME. Additionally, for targeted drug delivery, multiple cyclo[Arg-Gly-Asp-(d-Phe)-Cys] (cRGD) peptide units on DNA origami were employed. The incorporation of disulfide bonds allowed the release of multiple modules in response to intracellular glutathione (GSH) in tumors. The nanodevice promoted the infiltration of CD8+ and CD4+ cells into the tumor and generated a highly inflamed TME, thereby enhancing the effectiveness of cancer immunotherapy. Our research results indicate that the nanodevice we constructed can effectively inhibit tumor growth and prevent lung metastasis without obvious systemic toxicity, providing a promising strategy for cancer combination treatment.

Cell Membrane Hybrid Lipid Nanovesicles Enhance Innate Immunity for Synergistic Immunotherapy by Promoting Immunogenic Cell Death and cGAS Activation

Immunotherapy shows great therapeutic potential for long-term protection against tumor relapse and metastasis. Innate immune sensors, such as cyclic GMP-AMP synthase (cGAS) and stimulator of interferon genes (STING), dissolve DNA and induce type I interferon. Through activation of the cGAS/STING pathway, chemotherapy drugs and reversine (REV) may provide synergetic anti-tumor effects. Here, we prepared drug-loaded cell membrane hybrid lipid nanovesicles (LEVs) (designated LEV@DOX@REV) by fusion of cell membranes, phospholipids, doxorubicin (DOX), and REV, to realize accurate delivery to tumors and chemo-immunotherapy. The cell membranes of LEVs confer "homing" abilities. DOX can induce immunogenic cell death as a result of its specific immunomodulatory effects, which promotes the maturation of immune cells and improves the microenvironment of the immune system. REV is proven to efficiently activate cGAS/STING signaling, thereby enhancing the immune system. The antitumor efficacy of LEV@DOX@REV was evaluated in a 4T1 subcutaneous tumor xenograft model, a distant metastatic tumor model, and a liver metastatic tumor model. LEV@DOX@REV facilitated the infiltration of cytotoxic T lymphocytes within tumors, increased the secretion of proinflammatory cytokines, and modified the tumor microenvironment. In conclusion, LEV@DOX@REV displayed favorable antitumor effects and extended the survival of tumor-bearing mice. We therefore successfully developed nanoparticles capable of enhancing immune activation that have potential therapeutic applications for cancer immunotherapy.

Smart Stimuli-Responsive Spherical Nucleic Acids: Cutting-Edge Platforms for Biosensing, Bioimaging, and Therapeutics

Spherical nucleic acids (SNAs) with exceptional colloidal stability, multiple modularity, and programmability are excellent candidates to address common molecular delivery-related issues. Based on this, the higher targeting accuracy and enhanced controllability of stimuli-responsive SNAs render them precise nanoplatforms with inestimable prospects for diverse biomedical applications. Therefore, tailored diagnosis and treatment with stimuli-responsive SNAs may be a robust strategy to break through the bottlenecks associated with traditional nanocarriers. Various stimuli-responsive SNAs are engineered through the incorporation of multifunctional modifications to meet biomedical demands with the development of nucleic acid functionalization. This review provides a comprehensive overview of prominent research in this area and recent advancements in the utilization of stimuli-responsive SNAs in biosensing, bioimaging, and therapeutics. For each aspect, SNA nanoplatforms that exhibit responsive behavior to both internal stimuli (including sequence, enzyme, redox reactions, and pH) and external stimuli (such as light and temperature) are highlighted. This review is expected to offer inspiration and guidance strategies for the rational design and development of stimuli-responsive SNAs in the field of biomedicine.

Circulating immunotherapy strategy based on pyroptosis and STING pathway: Mn-loaded paclitaxel prodrug nanoplatform against tumor progression and metastasis

Immunotherapy has emerged as a promising strategy against tumors. However, its efficacy is limited by low immunogenicity, poor antigen presentation, and inadequate lymphocyte infiltration. Herein, we develop a nanoplatform (Mn-HSP) loaded with manganese ions (Mn2+) and paclitaxel (PTX) prodrug based on hyaluronic acid. PTX in Mn-HSP induces DNA damage and pyroptosis to release tumor-associated antigens (TAAs), enhancing tumor-specific adaptive immunity. Meanwhile, Mn2+ in Mn-HSP, together with PTX-induced DNA damage, activates the stimulator of interferon gene (STING) pathway to amplify innate immunity. Mn-HSP combines with adaptive and innate immunity, effectively enhancing the presentation of antigen-presenting cells (APCs) and promoting tumor infiltration of cytotoxic T lymphocytes (CTLs). In turn, the granzyme B (GZMB) secreted by CTLs triggers pyroptosis again, thereby establishing a "circulating immunotherapy" against tumors. Our results demonstrate that Mn-HSP efficiently inhibits primary breast tumors, as well as rechallenge tumors and lung metastasis in vivo. Therefore, the circulating immunotherapy that combines pyroptosis mediated adaptive immunity and STING pathway amplified innate immunity provides a novel strategy for enhancing tumor immunotherapy.

A Biomimetic Multifunctional Nanoframework for Symptom Relief and Restorative Treatment of Acute Liver Failure

Acute liver failure (ALF) is a rare and serious condition characterized by major hepatocyte death and liver dysfunction. Owing to the limited therapeutic options, this disease generally has a poor prognosis and a high mortality rate. When ALF cannot be reversed by medications, liver transplantation is often needed. However, transplant rejection and the shortage of donor organs still remain major challenges. Most recently, stem cell therapy has emerged as a promising alternative for the treatment of liver diseases. However, the limited cell delivery routes and poor stability of live cell products have greatly hindered the feasibility and therapeutic efficacy of stem cell therapy. Inspired by the functions of mesenchymal stem cells (MSCs) primarily through the secretion of several factors, we developed an MSC-inspired biomimetic multifunctional nanoframework (MBN) that encapsulates the growth-promoting factors secreted by MSCs via combination with hydrophilic or hydrophobic drugs. The red blood cell (RBC) membrane was coated with the MBN to enhance its immunological tolerance and prolong its circulation time in blood. Importantly, the MBN can respond to the oxidative microenvironment, where it accumulates and degrades to release the payload. In this work, two biomimetic nanoparticles, namely, rhein-encapsulated MBN (RMBN) and N-acetylcysteine (NAC)-encapsulated MBN (NMBN), were designed and synthesized. In lipopolysaccharide (LPS)/d-galactosamine (D-GalN)-induced and acetaminophen (APAP)-induced ALF mouse models, RMBN and NMBN could effectively target liver lesions, relieve the acute symptoms of ALF, and promote liver cell regeneration by virtue of their strong antioxidative, anti-inflammatory, and regenerative activities. This study demonstrated the feasibility of the use of an MSC-inspired biomimetic nanoframework for treating ALF.

Research Progress of Polysaccharide-Gold Nanocomplexes in Drug Delivery

Clinical drug administration aims to deliver drugs efficiently and safely to target tissues, organs, and cells, with the objective of enabling their therapeutic effects. Currently, the main approach to enhance a drug's effectiveness is ensuring its efficient delivery to the intended site. Due to the fact that there are still various drawbacks of traditional drug delivery methods, such as high toxicity and side effects, insufficient drug specificity, poor targeting, and poor pharmacokinetic performance, nanocarriers have emerged as a promising alternative. Nanocarriers possess significant advantages in drug delivery due to their size tunability and surface modifiability. Moreover, nano-drug delivery systems have demonstrated strong potential in terms of prolonging drug circulation time, improving bioavailability, increasing drug retention at the tumor site, decreasing drug resistance, as well as reducing the undesirable side effects of anticancer drugs. Numerous studies have focused on utilizing polysaccharides as nanodelivery carriers, developing delivery systems based on polysaccharides, or exploiting polysaccharides as tumor-targeting ligands to enhance the precision of nanoparticle delivery. These types of investigations have become commonplace in the academic literature. This review aims to elucidate the preparation methods and principles of polysaccharide gold nanocarriers. It also provides an overview of the factors that affect the loading of polysaccharide gold nanocarriers with different kinds of drugs. Additionally, it outlines the strategies employed by polysaccharide gold nanocarriers to improve the delivery efficiency of various drugs. The objective is to provide a reference for further development of research on polysaccharide gold nanodelivery systems.

Classification and design strategies of polysaccharide-based nano-nutrient delivery systems for enhanced bioactivity and targeted delivery: A review

Since many nutrients are highly sensitive, they cannot be absorbed and utilized efficiently by the body. Using nano-delivery systems to encapsulate nutrients is an effective method of solving the problems associated with the application of nutrients at this stage. Polysaccharides, as natural biomaterials, have a unique chemical structure, ideal biocompatibility, biodegradability and low immunogenicity. This makes polysaccharides powerful carriers that can enhance the biological activity of nutrients. However, the true role of polysaccharide-based delivery systems requires an in-depth understanding of the structural and physicochemical characteristics of polysaccharide-based nanodelivery systems, as well as effective modulation of the intestinal delivery mechanism and the latest advances in nano-encapsulation. This review provides an overview of polysaccharide-based nano-delivery systems dependent on different carrier types, emphasizing recent advances in the application of polysaccharides, a biocomposite material designed for nutrient delivery systems. Strategies for polysaccharide-based nano-delivery systems to enhance the bioavailability of orally administered nutrients from the perspective of the intestinal absorption barrier are presented. Characterization methods for polysaccharide-based nano-delivery systems are presented as well as an explanation of the formation mechanisms behind nano-delivery systems from the perspective of molecular forces. Finally, we discussed the challenges currently facing polysaccharide-based nano-delivery systems as well as possible future directions for the future.

Polysaccharides regulate Th1/Th2 balance: A new strategy for tumor immunotherapy

T helper (Th) cells have received extensive attention owing to their indispensable roles in anti-tumor immune responses. Th1 and Th2 cells are two key subsets of Th cells that exist in relative equilibrium through the secretion of cytokines that suppress their respective immune response. When the type of cytokine in the tumor microenvironment is altered, this equilibrium may be disrupted, leading to a shift from Th1 to Th2 immune response. Th1/Th2 imbalance is one of the decisive factors in the development of malignant tumors. Therefore, focusing on the balance of Th1/Th2 anti-tumor immune responses may enable future breakthroughs in cancer immunotherapy. Polysaccharides can regulate the imbalance between Th1 and Th2 cells and their characteristic cytokine profiles, thereby improving the tumor immune microenvironment. To our knowledge, this study is the most comprehensive assessment of the regulation of the tumor Th1/Th2 balance by polysaccharides. Herein, we systematically summarized the intrinsic molecular mechanisms of polysaccharides in the regulation of Th1 and Th2 cells to provide a new perspective and potential target drugs for improved anti-tumor immunity and delayed tumor progression.

Recent Advances of Tumor Microenvironment-Responsive Nanomedicines-Energized Combined Phototherapy of Cancers

Photodynamic therapy (PDT) has emerged as a powerful tumor treatment tool due to its advantages including minimal invasiveness, high selectivity and thus dampened side effects. On the other side, the efficacy of PDT is severely frustrated by the limited oxygen level in tumors, thus promoting its combination with other therapies, particularly photothermal therapy (PTT) for bolstered tumor treatment outcomes. Meanwhile, nanomedicines that could respond to various stimuli in the tumor microenvironment (TME) provide tremendous benefits for combined phototherapy with efficient hypoxia relief, tailorable drug release and activation, improved cellular uptake and intratumoral penetration of nanocarriers, etc. In this review, we will introduce the merits of combining PTT with PDT, summarize the recent important progress of combined phototherapies and their combinations with the dominant tumor treatment regimen, chemotherapy based on smart nanomedicines sensitive to various TME stimuli with a focus on their sophisticated designs, and discuss the challenges and future developments of nanomedicine-mediated combined phototherapies.

Polysaccharide-based tumor microenvironment-responsive drug delivery systems for cancer therapy

The biochemical indicators of tumor microenvironment (TME) that are different from normal tissues provide the possibility for constructing intelligent drug delivery systems (DDSs). Polysaccharides with good biocompatibility, biodegradability, and unique biological properties are ideal materials for constructing DDSs. Nanogels, micelles, organic-inorganic nanocomposites, hydrogels, and microneedles (MNs) are common polysaccharide-based DDSs. Polysaccharide-based DDSs enable precise control of drug delivery and release processes by incorporating TME-specific biochemical indicators. The classification and design strategies of polysaccharide-based TME-responsive DDSs are comprehensively reviewed. The advantages and challenges of current polysaccharide-based DDSs are summarized and the future directions of development are foreseen. The polysaccharide-based TME-responsive DDSs are expected to provide new strategies and solutions for cancer therapy and make important contributions to the realization of precision medicine.

Three Strategies in Engineering Nanomedicines for Tumor Microenvironment-Enabled Phototherapy

Canonical phototherapeutics have several limitations, including a lack of tumor selectivity, nondiscriminatory phototoxicity, and tumor hypoxia aggravation. The tumor microenvironment (TME) is characterized by hypoxia, acidic pH, and high levels of H2 O2 , GSH, and proteases. To overcome the shortcomings of canonical phototherapy and achieve optimal theranostic effects with minimal side effects, unique TME characteristics are employed in the development of phototherapeutic nanomedicines. In this review, the effectiveness of three strategies for developing advanced phototherapeutics based on various TME characteristics is examined. The first strategy involves targeted delivery of phototherapeutics to tumors with the assistance of TME-induced nanoparticle disassembly or surface modification. The second strategy involves near-infrared absorption increase-induced phototherapy activation triggered by TME factors. The third strategy involves enhancing therapeutic efficacy by ameliorating TME. The functionalities, working principles, and significance of the three strategies for various applications are highlighted. Finally, possible challenges and future perspectives for further development are discussed.

Controlled Drug Release from Nanoengineered Polysaccharides

Polysaccharides are naturally occurring complex molecules with exceptional physicochemical properties and bioactivities. They originate from plant, animal, and microbial-based resources and processes and can be chemically modified. The biocompatibility and biodegradability of polysaccharides enable their increased use in nanoscale synthesis and engineering for drug encapsulation and release. This review focuses on sustained drug release studies from nanoscale polysaccharides in the fields of nanotechnology and biomedical sciences. Particular emphasis is placed on drug release kinetics and relevant mathematical models. An effective release model can be used to envision the behavior of specific nanoscale polysaccharide matrices and reduce impending experimental trial and error, saving time and resources. A robust model can also assist in translating from in vitro to in vivo experiments. The main aim of this review is to demonstrate that any study that establishes sustained release from nanoscale polysaccharide matrices should be accompanied by a detailed analysis of drug release kinetics by modeling since sustained release from polysaccharides not only involves diffusion and degradation but also surface erosion, complicated swelling dynamics, crosslinking, and drug-polymer interactions. As such, in the first part, we discuss the classification and role of polysaccharides in various applications and later elaborate on the specific pharmaceutical processes of polysaccharides in ionic gelling, stabilization, cross-linking, grafting, and encapsulation of drugs. We also document several drug release models applied to nanoscale hydrogels, nanofibers, and nanoparticles of polysaccharides and conclude that, at times, more than one model can accurately describe the sustained release profiles, indicating the existence of release mechanisms running in parallel. Finally, we conclude with the future opportunities and advanced applications of nanoengineered polysaccharides and their theranostic aptitudes for future clinical applications.