Nitric oxide nano-prodrug platform with synchronous glutathione depletion and hypoxia relief for enhanced photodynamic cancer therapy

Photodynamic therapy of cancer using graphene nanomaterials

INTRODUCTION

High incidence and fatality rates of cancer remain a global challenge. The success of conventional treatment modalities is being questioned on account of adverse effects. Photodynamic therapy (PDT) is a potential alternative. It utilizes a combination of photosensitizer (PS), light and oxygen to target the tissues locally, thereby minimizing the damage to neighboring healthy tissues. Conventional PSs suffer from poor selectivity, high hydrophobicity and sub-optimal yield of active radicals. Graphene nanomaterials (GNs) exhibit interesting particulate and photophysical properties in the context of their use in PDT.

AREA COVERED

We focus on describing the mechanistic aspects of PDT-mediated elimination of cancer cells and the subsequent development of adaptive immunity. After covering up-to-date literature on the significant enhancement of PDT capability with GNs, we have discussed the probability of combining PDT with chemo-, immuno-, and photothermal therapy to make the treatment more effective.

EXPERT OPINION

GNs can be synthesized in various size ranges, and their biocompatibility can be improved through surface functionalization and doping. These can be used as PS to generate ROS or conjugated with other PS molecules for treating deep-seated tumors. With increasing evidence on biosafety, such materials offer hope as antitumor therapeutics.

Nitric Oxide‐Based Nanomedicines for Conquering TME Fortress: Say “NO” to Insufficient Tumor Treatment

Almost all cancer treatments are significantly limited by the strong tumor microenvironment (TME) fortress formed by abnormal vasculature, dense extracellular matrix (ECM), multidrug resistance (MDR) system, and immune “cold” environment. In the huge efforts of dismantling the TME fortress, nitric oxide (NO)‐based nanomedicines are increasingly occupying a central position and have already been identified as super “strong polygonal warriors” to dismantle TME fortress for efficient cancer treatment, benefiting from NO's unique physicochemical properties and extremely fascinating biological effects. However, there is a paucity of systematic review to elaborate on the progress and fundamental mechanism of NO‐based nanomedicines in oncology from this aspect. Herein, the key characteristics of TME fortress and the potential of NO in reprogramming TME are delineated and highlighted. The evolution of NO donors and the advantages of NO‐based nanomedicines are discussed subsequently. Moreover, the latest progress of NO‐based nanomedicines for solid tumors is comprehensively reviewed, including normalizing tumor vasculature, overcoming ECM barrier, reversing MDR, and reactivating the immunosuppression TME. Lastly, the prospects, limitations, and future directions on NO‐based nanomedicines for TME manipulation are discussed to provide new insights into the construction of more applicable anticancer nanomedicines.

Gas-assisted phototherapy for cancer treatment

Phototherapies, mainly including photodynamic and photothermal therapy, have made considerable strides in the field of cancer treatment. With the aid of phototherapeutic agents, reactive oxygen species (ROS) or heat are generated under light irradiation to selectively damage cancer cells. However, sole-modality phototherapy faces certain drawbacks, such as limited penetration of phototherapeutic agents into tumor tissues, inefficient ROS generation due to hypoxia, treatment-induced inflammation and resistance of tumor to treatment (e.g., high levels of antioxidants, expression of heat shock protein). Gas therapy, an emerging therapy approach that damages cancer cells by improving the level of certain gas at the tumor site, shows potential to overcome the challenges associated with phototherapies. In addition, with the rapid development of nanotechnology, gas-assisted phototherapy based on nanomedicines has emerged as a promising strategy to enhance the treatment efficacy. This review summarizes recent advances in gas-assisted phototherapy and discusses the prospects and challenges of this strategy in cancer phototherapy.

Nanomaterials-mediated photodynamic therapy and its applications in treating oral diseases

Oral diseases, such as dental caries, periodontitis and oral cancer, have a very high morbidity over the world. Basically, many oral diseases are commonly related to bacterial infections or cell malignant proliferation, and usually located on the superficial positions. These features allow the convenient and efficient application of photodynamic therapy (PDT) for oral diseases, since PDT is ideally suitable for the diseases on superficial sites and has been widely used for antimicrobial and anticancer therapy. Photosensitizers (PSs) are an essential element in PDT, which induce the generation of a large number of reactive oxygen species (ROS) upon absorption of specific lights. Almost all the PSs are small molecules and commonly suffered from various problems in the PDT environment, such as low solubility and poor stability. Recently, reports on the nanomedicine-based PDT have been well documented. Various functionalized nanomaterials can serve either as the PSs carriers or the direct PSs, thus enhancing the PDT efficacy. Herein, we aim to provide a comprehensive understanding of the features of different oral diseases and discuss the potential applications of nanomedicine-based PDT in the treatment of some common oral diseases. Also, the concerns and possible solutions for nanomaterials-mediated PDT are discussed.

Fluorescent COFs with a Highly Conjugated Structure for Combined Starvation and Gas Therapy

Covalent organic frameworks (COFs) show great potential in biomedicine, but the synthesis of fluorescent ones with a highly conjugated structure in mild conditions remains a challenge. Herein, we reported a facile method to synthesize a nanosized, highly conjugated, and N-enriched COF material with bright fluorescence and further integrated it as a novel nanoplatform for efficient cancer starvation/gas therapy. High surface area and a porous structure endowed COFs with large loading capacity for both glucose oxidase and l-arginine, while conjugated monomer and N-doping guaranteed bright fluorescence and relatively strong interactions between loaded cargos. Well-designed size allowed easy cell uptake of drug-loaded COFs, which finally resulted in a highly efficient starvation therapy by consuming large amounts of glucose in cancer cells. H₂O₂, the byproduct during glucose consumption, was made full use of oxidizing l-arginine to generate toxic NO. This constructed combined starvation and gas therapy and exhibited emerging antimigration performance. Both in vitro and in vivo experiments confirmed an excellent cancer therapeutic effect than a single therapy, and the novel therapeutic platform showed good biocompatibility. Detailed mechanism study demonstrated that cell apoptosis and lysosomal damage contributed most to the synergistic treatment. Our study developed a new strategy to synthesize highly conjugated COFs with fluorescence and reported the potential applications in cancer therapy.

Nitric oxide and thyroid carcinoma: A review

Thyroid carcinoma is the most common endocrine cancer in the world, and its incidence has been steadily increasing in recent years. Despite its relatively good prognosis, therapies have not improved greatly in recent years. Therefore, exploring new therapies for thyroid carcinoma represents an unmet need. Nitric oxide (NO) is a short-term endogenous signaling molecule that plays a vital role in various physiological and pathological processes and is synthesized by nitric oxide synthase (NOS). Many studies have been conducted over the past decades to explain its correlation to cancer. NO exerts a wide range of effects on cancer, involving angiogenesis, apoptosis, cell cycle, invasion, and metastasis. It also serves a dual function by promoting and halting tumor development simultaneously. The relationship between NO and thyroid carcinoma has been intensively studied and discussed. This paper reviews the role and molecular mechanism of NO in thyroid carcinoma and discusses potentials of prevention and treatment of thyroid carcinoma.