A Review of Thermo- and Ultrasound-Responsive Polymeric Systems for Delivery of Chemotherapeutic Agents

Recent advances of responsive scaffolds in bone tissue engineering

The investigation of bone defect repair has been a significant focus in clinical research. The gradual progress and utilization of different scaffolds for bone repair have been facilitated by advancements in material science and tissue engineering. In recent times, the attainment of precise regulation and targeted drug release has emerged as a crucial concern in bone tissue engineering. As a result, we present a comprehensive review of recent developments in responsive scaffolds pertaining to the field of bone defect repair. The objective of this review is to provide a comprehensive summary and forecast of prospects, thereby contributing novel insights to the field of bone defect repair.

Ultrasound-Responsive Nanobubbles for Combined siRNA-Cerium Oxide Nanoparticle Delivery to Bone Cells

This study aims to present an ultrasound-mediated nanobubble (NB)-based gene delivery system that could potentially be applied in the future to treat bone disorders such as osteoporosis. NBs are sensitive to ultrasound (US) and serve as a controlled-released carrier to deliver a mixture of Cathepsin K (CTSK) siRNA and cerium oxide nanoparticles (CeNPs). This platform aimed to reduce bone resorption via downregulating CTSK expression in osteoclasts and enhance bone formation via the antioxidant and osteogenic properties of CeNPs. CeNPs were synthesized and characterized using transmission electron microscopy and X-ray photoelectron spectroscopy. The mixture of CTSK siRNA and CeNPs was adsorbed to the surface of NBs using a sonication method. The release profiles of CTSK siRNA and CeNPs labeled with a fluorescent tag molecule were measured after low-intensity pulsed ultrasound (LIPUS) stimulation using fluorescent spectroscopy. The maximum release of CTSK siRNA and the CeNPs for 1 mg/mL of NB-(CTSK siRNA + CeNPs) was obtained at 2.5 nM and 1 µg/mL, respectively, 3 days after LIPUS stimulation. Then, Alizarin Red Staining (ARS) was applied to human bone marrow-derived mesenchymal stem cells (hMSC) and tartrate-resistant acid phosphatase (TRAP) staining was applied to human osteoclast precursors (OCP) to evaluate osteogenic promotion and osteoclastogenic inhibition effects. A higher mineralization and a lower number of osteoclasts were quantified for NB-(CTSK siRNA + CeNPs) versus control +RANKL with ARS (p < 0.001) and TRAP-positive staining (p < 0.01). This study provides a method for the delivery of gene silencing siRNA and CeNPs using a US-sensitive NB system that could potentially be used in vivo and in the treatment of bone fractures and disorders such as osteoporosis.

Ultrasound-responsive hyaluronic acid hydrogel of hydrocortisone to treat osteoarthritis

One of the practical ways to manage the disease flares of arthritis is using an intra-articular depot formulation of glucocorticoids. Hydrogels, as controllable drug delivery systems, are hydrophilic polymers with distinctive properties, such as remarkable water capacity and biocompatibility. This study aimed to design an injectable thermo-ultrasound-triggered drug carrier based on Pluronic® F-127, hyaluronic acid, and gelatin. The in situ hydrogel loaded by hydrocortison was developed and D-optimal design was used to formulate the process. The optimized hydrogel was combined with four different surfactants to better regulate the release rate. In situ gels composed of the hydrocortisone-loaded hydrogel and hydrocortisone-loaded mixed-micelle hydrogel were characterized. The hydrocortisone-loaded hydrogel and selected hydrocortisone-loaded mixed-micelle hydrogel showed a spherical shape and were nano-sized with a unique thermo-responsive nature able to prolong drug release. The ultrasound-triggered release study showed that drug release was time-dependent. By inducing osteoarthritis in a rat model, behavioral tests and histopathological analyses were carried out on the hydrocortisone-loaded hydrogel and a particular hydrocortisone-loaded mixed-micelle hydrogel. In vivo results showed that the selected hydrocortisone-loaded mixed-micelle hydrogel improved the status of the disease. Results highlighted the potential of ultrasound-responsive in situ-forming hydrogels as hopeful formulas for efficient treatment of arthritis.

Responsive Nanostructure for Targeted Drug Delivery

Currently, intelligent, responsive biomaterials have been widely explored, considering the fact that responsive biomaterials provide controlled and predictable results in various biomedical systems. Responsive nanostructures undergo reversible or irreversible changes in the presence of a stimulus, and that stimuli can be temperature, a magnetic field, ultrasound, pH, humidity, pressure, light, electric field, etc. Different types of stimuli being used in drug delivery shall be explained here. Recent research progress in the design, development and applications of biomaterials comprising responsive nanostructures is also described here. More emphasis will be given on the various nanostructures explored for the smart stimuli responsive drug delivery at the target site such as wound healing, cancer therapy, inflammation, and pain management in order to achieve the improved efficacy and sustainability with the lowest side effects. However, it is still a big challenge to develop well-defined responsive nanostructures with ordered output; thus, challenges faced during the design and development of these nanostructures shall also be included in this article. Clinical perspectives and applicability of the responsive nanostructures in the targeted drug delivery shall be discussed here.

Recent advances of polymer based nanosystems in cancer management

Cancer is still one of the leading causes of death worldwide. Nanotechnology, particularly nanoparticle-based platforms, is at the leading edge of current cancer management research. Polymer-based nanosystems have piqued the interest of researchers owing to their many benefits over other conventional drug delivery systems. Polymers derived from both natural and synthetic sources have various biomedical applications due to unique qualities like porosity, mechanical strength, biocompatibility, and biodegradability. Polymers such as poly(lactic-co-glycolic acid) (PLGA), polycaprolactone (PCL), and polyethylene glycol (PEG) have been approved by the USFDA and are being researched for drug delivery applications. They have been reported to be potential carriers for drug loading and are used in theranostic applications. In this review, we have primarily focused on the aforementioned polymers and their conjugates. In addition, the therapeutic and diagnostic implications of polymer-based nanosystems have been briefly reviewed. Furthermore, the safety of the developed polymeric formulations is crucial, and we have discussed their biocompatibility in detail. This article also discusses recent developments in block co-polymer-based nanosystems for cancer treatment. The review ends with the challenges of clinical translation of polymer-based nanosystems in drug delivery for cancer therapy.

Ultrasound-Induced Drug Release from Stimuli-Responsive Hydrogels

Stimuli-responsive hydrogel drug delivery systems are designed to release a payload when prompted by an external stimulus. These platforms have become prominent in the field of drug delivery due to their ability to provide spatial and temporal control for drug release. Among the different external triggers that have been used, ultrasound possesses several advantages: it is non-invasive, has deep tissue penetration, and can safely transmit acoustic energy to a localized area. This review summarizes the current state of understanding about ultrasound-responsive hydrogels used for drug delivery. The mechanisms of inducing payload release and activation using ultrasound are examined, along with the latest innovative formulations and hydrogel design strategies. We also report on the most recent applications leveraging ultrasound activation for both cancer treatment and tissue engineering. Finally, the future perspectives offered by ultrasound-sensitive hydrogels are discussed.

Polymer-drug conjugates: Design principles, emerging synthetic strategies and clinical overview

Adagen, an enzyme replacement treatment for adenosine deaminase deficiency, was the first protein-polymer conjugate to be approved in early 1990s. Post this regulatory approval, numerous polymeric drugs and polymeric nanoparticles have entered the market as advanced or next-generation polymer-based therapeutics, while many others have currently been tested clinically. The polymer conjugation to therapeutic moiety offers several advantages, like enhanced solubilization of drug, controlled release, reduced immunogenicity, and prolonged circulation. The present review intends to highlight considerations in the design of therapeutically effective polymer-drug conjugates (PDCs), including the choice of linker chemistry. The potential synthetic strategies to formulate PDCs have been discussed along with recent advancements in the different types of PDCs, i.e., polymer-small molecular weight drug conjugates, polymer-protein conjugates, and stimuli-responsive PDCs, which are under clinical/preclinical investigation. Current impediments and regulatory hurdles hindering the clinical translation of PDC into effective therapeutic regimens for the amelioration of disease conditions have been addressed.

Toward closed-loop drug delivery: Integrating wearable technologies with transdermal drug delivery systems

The recent advancement and prevalence of wearable technologies and their ability to make digital measurements of vital signs and wellness parameters have triggered a new paradigm in the management of diseases. Drug delivery as a function of stimuli or response from wearable, closed-loop systems can offer real-time on-demand or preprogrammed drug delivery capability and offer total management of disease states. Here we review the key opportunities in this space for development of closed-loop systems, given the advent of digital wearable technologies. Particular considerations and focus are given to closed-loop systems combined with transdermal drug delivery technologies.

Ultrasound-Responsive Systems as Components for Smart Materials

Smart materials can respond to stimuli and adapt their responses based on external cues from their environments. Such behavior requires a way to transport energy efficiently and then convert it for use in applications such as actuation, sensing, or signaling. Ultrasound can carry energy safely and with low losses through complex and opaque media. It can be localized to small regions of space and couple to systems over a wide range of time scales. However, the same characteristics that allow ultrasound to propagate efficiently through materials make it difficult to convert acoustic energy into other useful forms. Recent work across diverse fields has begun to address this challenge, demonstrating ultrasonic effects that provide control over physical and chemical systems with surprisingly high specificity. Here, we review recent progress in ultrasound–matter interactions, focusing on effects that can be incorporated as components in smart materials. These techniques build on fundamental phenomena such as cavitation, microstreaming, scattering, and acoustic radiation forces to enable capabilities such as actuation, sensing, payload delivery, and the initiation of chemical or biological processes. The diversity of emerging techniques holds great promise for a wide range of smart capabilities supported by ultrasound and poses interesting questions for further investigations.

Current state of therapeutic focused ultrasound applications in neuro-oncology

INTRODUCTION

Despite manifold advances in oncology, cancers of the central nervous system remain among the most lethal. Unique features of the brain, including distinct cellular composition, immunological privilege, and physical barriers to therapeutic delivery, likely contribute to the poor prognosis of patients with neuro-oncological disease. Focused ultrasound is an emerging technology that allows transcranial delivery of ultrasound energy to focal brain targets with great precision.

METHODS

A review of the clinical and preclinical focused ultrasound literature was performed to obtain data regarding the current state of the focused ultrasound in context of neuro-oncology. A narrative review was then constructed to provide an overview of current and future applications of this technology.

RESULTS

Focused ultrasound can facilitate direct control of tumors by thermal or mechanical ablation, as well as enhance delivery of diverse therapeutics by disruption of the blood-brain barrier without local tissue damage. Indeed, ultrasound-sensitive drug formulations or sonosensitizers may be combined with ultrasound blood-brain barrier disruption to achieve high local drug concentration while limiting systemic exposure to therapeutics. Furthermore, focused ultrasound can induce radiosensitization, immunomodulation, and neuromodulation. Here we review applications of focused ultrasound with a focus on approaches currently under clinical investigation for the treatment of neuro-oncological disease, such as blood-brain barrier disruption for drug delivery and thermal ablation. We also discuss design of clinical trials, selection of patient cohorts, and emerging approaches to improve the efficacy of transcranial ultrasound, such as histotripsy, as well as combinatorial strategies to exploit synergistic biological effects of existing cancer therapies and ultrasound.

CONCLUSIONS

Focused ultrasound is a promising and actively expanding therapeutic modality for diverse neuro-oncological diseases.

Smart gating porous particles as new carriers for drug delivery

The design of smart drug delivery carriers has recently attracted great attention in the biomedical field. Smart carriers can specifically respond to physical and chemical changes in their environment, such as temperature, photoirradiation, ultrasound, magnetic field, pH, redox species, and biomolecules. This review summarizes recent advances in the integration of porous particles and stimuli-responsive gatekeepers for effective drug delivery. Their unique structural properties play an important role in facilitating the diffusion of drug molecules and cell attachment. Various techniques for fabricating porous materials, with their major advantages and limitations, are summarized. Smart gatekeepers provide advanced functions such as "open-close" switching by functionalized stimuli-responsive polymers on a particle's pores. These controlled delivery systems enable drugs to be targeted at specific rates, time programs, and sites of the human body. The gate structures, gating mechanisms, and controlled release mechanisms of each trigger are detailed. Current ongoing research and future trends in targeted drug delivery, tissue engineering, and regenerative medicine applications are highlighted.

Oxidation-Sensitive Core-Multishell Nanocarriers for the Controlled Delivery of Hydrophobic Drugs

A synthetic route for oxidation-sensitive core-multishell (osCMS) nanocarriers was established, and their drug loading and release properties were analyzed based on their structural variations. The nanocarriers showed a drug loading of 0.3-3 wt % for the anti-inflammatory drugs rapamycin and dexamethasone and the photosensitizer meso-tetra-hydroxyphenyl-porphyrin (mTHPP). Oxidative processes of the nanocarriers were probed in vitro by hydrogen peroxide, and the degradation products were identified by infrared spectroscopy supported by ab initio calculations, yielding mechanistic details on the chemical changes occurring in redox-sensitive nanocarriers. Oxidation-triggered drug release of the model drug Nile Red measured and assessed by time-dependent fluorescence spectroscopy showed a release of up to 80% within 24 h. The drug delivery capacity of the new osCMS nanocarriers was tested in ex vivo human skin with and without pretreatments to induce local oxidative stress. It was found that the delivery of mTHPP was selectively enhanced in skin under oxidative stress. The number and position of the thioether groups influenced the physicochemical as well as drug delivery properties of the carriers.

Influence of Salt on the Self-Organization in Solutions of Star-Shaped Poly-2-alkyl-2-oxazoline and Poly-2-alkyl-2-oxazine on Heating

The water-salt solutions of star-shaped six-arm poly-2-alkyl-2-oxazines and poly-2-alkyl-2-oxazolines were studied by light scattering and turbidimetry. The core was hexaaza[26]orthoparacyclophane and the arms were poly-2-ethyl-2-oxazine, poly-2-isopropyl-2-oxazine, poly-2-ethyl-2-oxazoline, and poly-2-isopropyl-2-oxazoline. NaCl and N-methylpyridinium p-toluenesulfonate were used as salts. Their concentration varied from 0-0.154 M. On heating, a phase transition was observed in all studied solutions. It was found that the effect of salt on the thermosensitivity of the investigated stars depends on the structure of the salt and polymer and on the salt content in the solution. The phase separation temperature decreased with an increase in the hydrophobicity of the polymers, which is caused by both a growth of the side radical size and an elongation of the monomer unit. For NaCl solutions, the phase separation temperature monotonically decreased with growth of salt concentration. In solutions with methylpyridinium p-toluenesulfonate, the dependence of the phase separation temperature on the salt concentration was non-monotonic with minimum at salt concentration corresponding to one salt molecule per one arm of a polymer star. Poly-2-alkyl-2-oxazine and poly-2-alkyl-2-oxazoline stars with a hexaaza[26]orthoparacyclophane core are more sensitive to the presence of salt in solution than the similar stars with a calix[n]arene branching center.

Ultrasound-responsive polymer-based drug delivery systems

Ultrasound-responsive polymeric materials have received a tremendous amount of attention from scientists for several decades. Compared to other stimuli-responsive materials (such as UV-, thermal-, and pH-responsive materials), these smart materials are more applicable since they allow more efficient drug delivery and targeted treatment by fairly non-invasive means. This review describes the recent advances of such ultrasound-responsive polymer-based drug delivery systems and illustrates various applications. More specifically, the mechanism of ultrasound-induced drug delivery, typical formulations, and biomedical applications (tumor therapy, disruption of blood-brain barrier, fighting infectious diseases, transdermal drug delivery, and enhanced thrombolysis) are summarized. Finally, a perspective on the future research directions for the development of ultrasound-responsive polymeric materials to facilitate a clinical translation is given.

Formation of Single Double-Layered Coacervate of Poly(N,N-diethylacrylamide) in Water by a Laser Tweezer

We demonstrate liquid-liquid phase separation involving both coacervation and coil-to-globule phase transition of a thermoresponsive polymer. By focusing a near-infrared laser beam into an aqueous solution of poly(N-isopropylacrylamide) (PNIPAM), a single phase-separated polymer microdroplet can be formed and stably trapped at the focal point. Such droplet formation is induced by a local elevation in temperature (induced by a photothermal effect) and an optical force. The technique allows us to selectively analyze a single polymer droplet trapped at the focal point. In this study, we applied this technique to poly(N,N-diethylacrylamide) (PDEA) in water and generated a double-layered PDEA droplet. Such an inhomogeneous and complex microstructure has not been previously observed both in steady-state heating of a PDEA solution and in the PNIPAM system. Moreover, we used micro-Raman spectroscopy to clarify that PDEA underwent dehydration due to a coil-to-globule phase transition. Despite this, the polymer concentration (C_poly) of the trapped PDEA droplet was very low and was around 30 wt %. C_poly depended on the molecular weight of PDEA and the laser power that regulates the temperature elevation. These results strongly indicate that PDEA undergoes coacervation in addition to a coil-to-globule phase transition. This study will help provide us with a fundamental understanding of the phase separation mechanisms of thermoresponsive polymers.

Emerging Role of Hydrogels in Drug Delivery Systems, Tissue Engineering and Wound Management

The popularity of hydrogels as biomaterials lies in their tunable physical properties, ability to encapsulate small molecules and macromolecular drugs, water holding capacity, flexibility, and controllable degradability. Functionalization strategies to overcome the deficiencies of conventional hydrogels and expand the role of advanced hydrogels such as DNA hydrogels are extensively discussed in this review. Different types of cross-linking techniques, materials utilized, procedures, advantages, and disadvantages covering hydrogels are tabulated. The application of hydrogels, particularly in buccal, oral, vaginal, and transdermal drug delivery systems, are described. The review also focuses on composite hydrogels with enhanced properties that are being developed to meet the diverse demand of wound dressing materials. The unique advantages of hydrogel nanoparticles in targeted and intracellular delivery of various therapeutic agents are explained. Furthermore, different types of hydrogel-based materials utilized for tissue engineering applications and fabrication of contact lens are discussed. The article also provides an overview of selected examples of commercial products launched particularly in the area of oral and ocular drug delivery systems and wound dressing materials. Hydrogels can be prepared with a wide variety of properties, achieving biostable, bioresorbable, and biodegradable polymer matrices, whose mechanical properties and degree of swelling are tailored with a specific application. These unique features give them a promising future in the fields of drug delivery systems and applied biomedicine.

3D and 4D printing in dentistry and maxillofacial surgery: Printing techniques, materials, and applications

3D and 4D printing are cutting-edge technologies for precise and expedited manufacturing of objects ranging from plastic to metal. Recent advances in 3D and 4D printing technologies in dentistry and maxillofacial surgery enable dentists to custom design and print surgical drill guides, temporary and permanent crowns and bridges, orthodontic appliances and orthotics, implants, mouthguards for drug delivery. In the present review, different 3D printing technologies available for use in dentistry are highlighted together with a critique on the materials available for printing. Recent reports of the application of these printed platformed are highlighted to enable readers appreciate the progress in 3D/4D printing in dentistry.

Hydroxyapatite sonosensitization of ultrasound-triggered, thermally responsive hydrogels: An on-demand delivery system for bone repair applications

While bones have the innate capability to physiologically regenerate, in certain cases regeneration is suboptimal, too slow, or does not occur. Biomaterials-based growth factor delivery systems have shown potential for the treatment of challenging bone defects, however, achieving controlled growth factor release remains a challenge. The objective of this study was to develop a thermally responsive hydrogel for bone regeneration capable of ultrasound-triggered on-demand delivery of therapeutic agents. Furthermore, it was hypothesized that incorporation of hydroxyapatite (HA) into the hydrogel could increase sonosensitization, augmenting ultrasound sensitivity to enable controlled therapeutic release to the target tissue. Alginate thermally responsive P(Alg-g-NIPAAm) hydrogels were fabricated and varying quantities of HA (1, 3, 5, and 7% wt./vol.) incorporated. All hydrogels were highly injectable (maximum injection force below 6.5 N) and rheological characterization demonstrated their ability to gel at body temperature. The study demonstrated the ultrasound-triggered release of sodium fluorescein (NaF), bovine serum albumin (BSA), and bone morphogenetic protein 2 (BMP-2) from the hydrogels. Release rates of BSA and BMP-2 were significantly enhanced in the HA containing hydrogels, confirming for the first time the role of HA as a son sensitizer. Together these results demonstrate the potential of these ultrasound-triggered thermally responsive hydrogels for on-demand delivery of therapeutic agents for bone regeneration.

Recent Advancements in Stimuli Responsive Drug Delivery Platforms for Active and Passive Cancer Targeting

The tumor-specific targeting of chemotherapeutic agents for specific necrosis of cancer cells without affecting the normal cells poses a great challenge for researchers and scientists. Though extensive research has been carried out to investigate chemotherapy-based targeted drug delivery, the identification of the most promising strategy capable of bypassing non-specific cytotoxicity is still a major concern. Recent advancements in the arena of onco-targeted therapies have enabled safe and effective tumor-specific localization through stimuli-responsive drug delivery systems. Owing to their promising characteristic features, stimuli-responsive drug delivery platforms have revolutionized the chemotherapy-based treatments with added benefits of enhanced bioavailability and selective cytotoxicity of cancer cells compared to the conventional modalities. The insensitivity of stimuli-responsive drug delivery platforms when exposed to normal cells prevents the release of cytotoxic drugs into the normal cells and therefore alleviates the off-target events associated with chemotherapy. Contrastingly, they showed amplified sensitivity and triggered release of chemotherapeutic payload when internalized into the tumor microenvironment causing maximum cytotoxic responses and the induction of cancer cell necrosis. This review focuses on the physical stimuli-responsive drug delivery systems and chemical stimuli-responsive drug delivery systems for triggered cancer chemotherapy through active and/or passive targeting. Moreover, the review also provided a brief insight into the molecular dynamic simulations associated with stimuli-based tumor targeting.

Ultrasound-Responsive Carriers for Therapeutic Applications

Ultrasound (US)-responsive carriers have emerged as promising theranostic candidates because of their ability to enhance US-contrast, promote image-guided drug delivery, cause on-demand pulsatile release of drugs in response to ultrasound stimuli, as well as to enhance the permeability of physiological barriers such as the stratum corneum, the vascular endothelium, and the blood-brain barrier (BBB). US-responsive carriers include microbubbles MBs, liposomes, droplets, hydrogels, and nanobubble-nanoparticle complexes and have been explored for cavitation-mediated US-responsive drug delivery. Recently, a transient increase in the permeability of the BBB by microbubble (MB)-assisted low-frequency US has shown promise in enhancing the delivery of therapeutic agents in the case of neurological disorders. Further, the periodic mechanical stimulus generated by US-responsive MBs have also been explored in tissue engineering and has directly influenced the differentiation of mesenchymal stem cells into cartilage. This Review discusses the various types of US-responsive carriers and explores their emerging roles in therapeutics ranging from drug delivery to tissue engineering.

Emerging Strategies in Stimuli-Responsive Nanocarriers as the Drug Delivery System for Enhanced Cancer Therapy

The conventional Drug Delivery System (DDS) has limitations such as leakage of the drug, toxicity to normal cells and loss of drug efficiency, while the stimuli-responsive DDS is non-toxic to cells, avoiding the leakage and degradation of the drug because of its targeted drug delivery to the pathological site. Thus nanomaterial chemistry enables - the development of smart stimuli-responsive DDS over the conventional DDS. Stimuliresponsive DDS ensures spatial or temporal, on-demand drug delivery to the targeted cancer cells. The DDS is engineered by using the organic (synthetic polymers, liposomes, peptides, aptamer, micelles, dendrimers) and inorganic (zinc oxide, gold, magnetic, quantum dots, metal oxides) materials. Principally, these nanocarriers release the drug at the targeted cells in response to external and internal stimuli such as temperature, light, ultrasound and magnetic field, pH value, redox potential (glutathione), and enzyme. The multi-stimuli responsive DDS is more promising than the single stimuli-responsive DDS in cancer therapy, and it extensively increases drug release and accumulation in the targeted cancer cells, resulting in better tumor cell ablation. In this regard, a handful of multi-stimuli responsive DDS is in clinical trials for further approval. A comprehensive review is crucial for addressing the existing knowledge about multi-stimuli responsive DDS, and hence, we summarized the emerging strategies in tailored ligand functionalized stimuli-responsive nanocarriers as the DDS for cancer therapies.

Recent advances in theranostic polymeric nanoparticles for cancer treatment: A review

Nanotheranostics is fast-growing pharmaceutical technology for simultaneously monitoring drug release and its distribution, and to evaluate the real time therapeutic efficacy through a single nanoscale for treatment and diagnosis of deadly disease such as cancers. In recent two decades, biodegradable polymers have been discovered as important carriers to accommodate therapeutic and medical imaging agents to facilitate construction of multi-modal formulations. In this review, we summarize various multifunctional polymeric nano-sized formulations such as polymer-based super paramagnetic nanoparticles, ultrasound-triggered polymeric nanoparticles, polymeric nanoparticles bearing radionuclides, and fluorescent polymeric nano-sized formulations for purpose of theranostics. The use of such multi-modal nano-sized formulations for near future clinical trials can assist clinicians to predict therapeutic properties (for instance, depending upon the quantity of drug accumulated at the cancerous site) and observed the progress of tumor growth in patients, thus improving tailored medicines.

Synthesis and Applications of Hydrogels in Cancer Therapy

Hydrogels are water-insoluble, hydrophilic, cross-linked, three-dimensional networks of polymer chains having the ability to swell and absorb water but do not dissolve in it, that comprise the major difference between gels and hydrogels. The mechanical strength, physical integrity and solubility are offered by the crosslinks. The different applications of hydrogels can be derived based on the methods of their synthesis, response to different stimuli, and their different kinds. Hydrogels are highly biocompatible and have properties similar to human tissues that make it suitable to be used in various biomedical applications, including drug delivery and tissue engineering. The role of hydrogels in cancer therapy is highly emerging in recent years. In the present review, we highlighted different methods of synthesis of hydrogels and their classification based on different parameters. Distinctive applications of hydrogels in the treatment of cancer are also discussed.

Recent advances of nanomedicines for liver cancer therapy

This review highlights recent advancements in nanomedicines for liver cancer therapy.

Efficacy of several additives to modulate the phase behavior of biomedical polymers: A comprehensive and comparative outlook

Several new classes of polymeric materials are being introduced with unique properties. Thermoresponsive polymers (TRPs) are one of the most fascinating and emerging class of biomaterials in biomedical research. The design of TRPs with good response to temperature and its ability to exhibit coil to globular transition behavior near to physiological temperature made them more promising materials in the field of biomaterials and biomedicines. Instead of numerous studies on TRPs, the mechanistic interplay among several additives and TRPs is still not understood clearly and completely. The lack of complete understanding of biomolecular interactions of various additives with TRPs is limiting their applications in interdisciplinary science as well as pharmaceutical industry. There is a great need to provide a collective and comprehensive information of various additives and their behavior on widely accepted biopolymers, TRPs such as poly(N-isopropylacrylamide) (PNIPAM), poly(vinyl methyl ether) (PVME), poly(N-vinylcaprolactum) (PVCL) and poly(ethylene glycol)-poly(propylene glycol)-poly(ethylene glycol) (PEG-PPG-PEG) in aqueous solution. Obviously, as the literature on the influence of various additives on TRPs is very vast, therefore we focus our review only on these four selected TRPs. Additives such as polyols, methylamines, surfactants and denaturants basically made the significant changes in water structure associated to polymer via their entropy variation which is the direct influence of their directly or indirectly binding abilities. Eventually, this review addresses a brief overview of the most recent literature of applications based phase behavior of four selected TRPs in response to external stimuli. The work enhances the knowledge for use of TRPs in the advanced development of drug delivery system and in many more pharmaceutical applications. These kinds of studies provide powerful impact in exploring the utility range of polymeric materials in various field of science.

Nano-Enhanced Drug Delivery and Therapeutic Ultrasound for Cancer Treatment and Beyond

While ultrasound is most widely known for its use in diagnostic imaging, the energy carried by ultrasound waves can be utilized to influence cell function and drug delivery. Consequently, our ability to use ultrasound energy at a given intensity unlocks the opportunity to use the ultrasound for therapeutic applications. Indeed, in the last decade ultrasound-based therapies have emerged with promising treatment modalities for several medical conditions. More recently, ultrasound in combination with nanomedicines, i.e., nanoparticles, has been shown to have substantial potential to enhance the efficacy of many treatments including cancer, Alzheimer disease or osteoarthritis. The concept of ultrasound combined with drug delivery is still in its infancy and more research is needed to unfold the mechanisms and interactions of ultrasound with different nanoparticles types and with various cell types. Here we present the state-of-art in ultrasound and ultrasound-assisted drug delivery with a particular focus on cancer treatments. Notably, this review discusses the application of high intensity focus ultrasound for non-invasive tumor ablation and immunomodulatory effects of ultrasound, as well as the efficacy of nanoparticle-enhanced ultrasound therapies for different medical conditions. Furthermore, this review presents safety considerations related to ultrasound technology and gives recommendations in the context of system design and operation.

Recent Progress and Advances of Multi-Stimuli-Responsive Dendrimers in Drug Delivery for Cancer Treatment

Despite the fact that nanocarriers as drug delivery systems overcome the limitation of chemotherapy, the leakage of encapsulated drugs during the delivery process to the target site can still cause toxic effects to healthy cells in other tissues and organs in the body. Controlling drug release at the target site, responding to stimuli that originated from internal changes within the body, as well as stimuli manipulated by external sources has recently received significant attention. Owning to the spherical shape and porous structure, dendrimer is utilized as a material for drug delivery. Moreover, the surface region of dendrimer has various moieties facilitating the surface functionalization to develop the desired material. Therefore, multi-stimuli-responsive dendrimers or 'smart' dendrimers that respond to more than two stimuli will be an inspired attempt to achieve the site-specific release and reduce as much as possible the side effects of the drug. The aim of this review was to delve much deeper into the recent progress of multi-stimuli-responsive dendrimers in the delivery of anticancer drugs in addition to the major potential challenges.

Design strategies for physical-stimuli-responsive programmable nanotherapeutics

Nanomaterials that respond to externally applied physical stimuli such as temperature, light, ultrasound, magnetic field and electric field have shown great potential for controlled and targeted delivery of therapeutic agents. However, the body of literature on programming these stimuli-responsive nanomaterials to attain the desired level of pharmacologic responses is still fragmented and has not been systematically reviewed. The purpose of this review is to summarize and synthesize the literature on various design strategies for simple and sophisticated programmable physical-stimuli-responsive nanotherapeutics.

Advances in thermosensitive polymer-grafted platforms for biomedical applications

Studies on "smart" polymeric material performing environmental stimuli such as temperature, pH, magnetic field, enzyme and photo-sensation have recently paid much attention to practical applications. Among of them, thermo-responsive grafted copolymers, amphiphilic steroids as well as polyester molecules have been utilized in the fabrication of several multifunctional platforms. Indeed, they performed a strikingly functional improvement comparing to some original materials and exhibited a holistic approach for biomedical applications. In case of drug delivery systems (DDS), there has been some successful proof of thermal-responsive grafted platforms on clinical trials such as ThermoDox®, BIND-014, Cynviloq IG-001, Genexol-PM, etc. This review would detail the recent progress and highlights of some temperature-responsive polymer-grafted nanomaterials or hydrogels in the 'smart' DDS that covered from synthetic polymers to nature-driven biomaterials and novel generations of some amphiphilic functional platforms. These approaches could produce several types of smart biomaterials for human health care in future.

Thermo-Responsive Starch-g-(PAM-co-PNIPAM): Controlled Synthesis and Effect of Molecular Components on Solution Rheology

A series of highly branched random copolymers of acrylamide (AM) and N-isopropylacrylamide (NIPAM) have been prepared from a waxy potato starch-based macroinitiator by aqueous Cu⁰-mediated living radical polymerization (Cu⁰-mediated LRP). The NIPAM intake in the copolymer was varied between 0% and 50 mol % to evaluate the influence of chain composition on the aqueous rheological properties as well as their low critical solution temperature (LCST). The viscosity of the copolymer was found to increase with the NIPAM intake and an LCST can be observed when the NIPAM content is high enough (e.g., 50 mol %). In addition, thermo-thickening behavior was observed at a low shear rate (γ ≤ 10 s-1) and higher NIPAM content was found to shift the onset of thermo-thickening behavior to a lower temperature. However, the absolute increase in viscosity values is reduced with the NIPAM intake. Besides this, an interesting significant thermo-thickening behavior was also observed on highly branched starch-g-polyacrylamide at high temperatures (>80 °C), which has not been previously reported. Rheology tests also revealed a good salt-resistant property in copolymers with low NIPAM content (e.g., <25 mol %). Considering the viscosity profile in saline as compared to that in pure water, this NIPAM intake seems to represent an optimum balance of viscosity and salt-resistance performance.

Main-chain polyacetal conjugates with HIF-1 inhibitors: temperature-responsive, pH-degradable drug delivery vehicles

Main-chain polymer-drug conjugates are prepared from polyacetals (PA) and three hydrophobic diol-based HIF-1 inhibitors. The new conjugates are temperature-responsive with lower critical solution temperature (LCST) behavior and are intrinsically pH-degradable. While soluble in plasma at room temperature, they lose solubility above a target temperature that can be adjusted to virtually any temperature of physicological interest, providing mechanisms for site-specific delivery by active thermal targeting or temperature-induced gelation. The reverse phase transition temperature can be precisely tuned by proper choice of four structural variables that characterize the amphiphilic diol and divinyl ether monomers used in the synthesis, or by adjusting the content of drug incorporated within the polymer. These main-chain PA-drug conjugates also allow for site-specific controlled release as they degrade in acidic microenvironments such as tumors. The degradation rates increase with decreasing pH, degradation products are neutral, and pristine drug is released, without any remnants of the conjugation chemistry.

Dual controlled delivery of squalenoyl-gemcitabine and paclitaxel using thermo-responsive polymeric micelles for pancreatic cancer

A thermoresponsive block copolymer has been developed with the capability to co-carry two drug molecules and to augment their cytotoxic properties via direct cell membrane interaction with cancer cells.

pH Sensitive Hydrogels in Drug Delivery: Brief History, Properties, Swelling, and Release Mechanism, Material Selection and Applications

Improving the safety efficacy ratio of existing drugs is a current challenge to be addressed rather than the development of novel drugs which involve much expense and time. The efficacy of drugs is affected by a number of factors such as their low aqueous solubility, unequal absorption along the gastrointestinal (GI) tract, risk of degradation in the acidic milieu of the stomach, low permeation of the drugs in the upper GI tract, systematic side effects, etc. This review aims to enlighten readers on the role of pH sensitive hydrogels in drug delivery, their mechanism of action, swelling, and drug release as a function of pH change along the GI tract. The basis for the selection of materials, their structural features, physical and chemical properties, the presence of ionic pendant groups, and the influence of their pKa and pKb values on the ionization, consequent swelling, and targeted drug release are also highlighted.

Sum frequency generation vibrational spectroscopy of methacrylate-based functional monomers at the hydrophilic solid–liquid interface

An SFGVS study showed H-bonding interactions between the carbonyl groups of methacrylate liquid monomers and surface silanol groups of amorphous quartz.