Department of Biomedical Engineering, School of Engineering, China Pharmaceutical University, 639 Longmian Road, Jiangning District, Nanjing 210009, China.
Biomater Sci. 2021 Dec 21;10(1):51-84. doi: 10.1039/d1bm00317h.
Cancer is a leading cause of death worldwide, accounting for an estimated 10 million deaths by 2020. Over the decades, various strategies for tumor therapy have been developed and evaluated. Photodynamic therapy (PDT) has attracted increasing attention due to its unique characteristics, including low systemic toxicity and minimally invasive nature. Despite the excellent clinical promise of PDT, hypoxia is still the Achilles' heel associated with its oxygen-dependent nature related to increased tumor proliferation, angiogenesis, and distant metastases. Moreover, PDT-mediated oxygen consumption further exacerbates the hypoxia condition, which will eventually lead to the poor effect of drug treatment and resistance and irreversible tumor metastasis, even limiting its effective application in the treatment of hypoxic tumors. Hypoxia, with increased oxygen consumption, may occur in acute and chronic hypoxia conditions in developing tumors. Tumor cells farther away from the capillaries have much lower oxygen levels than cells in adjacent areas. However, it is difficult to change the tumor's deep hypoxia state through different ways to reduce the tumor tissue's oxygen consumption. Therefore, it will become more difficult to cure malignant tumors completely. In recent years, numerous investigations have focused on improving PDT therapy's efficacy by providing molecular oxygen directly or indirectly to tumor tissues. In this review, different molecular oxygen supplementation methods are summarized to alleviate tumor hypoxia from the innovative perspective of using supplemental oxygen. Besides, the existing problems, future prospects and potential challenges of this strategy are also discussed.
癌症是全球主要的死亡原因,据估计,到 2020 年将有 1000 万人因此死亡。几十年来,已经开发并评估了各种肿瘤治疗策略。光动力疗法(PDT)因其独特的特性,包括低全身毒性和微创性,而受到越来越多的关注。尽管 PDT 在临床应用上有很好的前景,但缺氧仍然是其与氧气依赖性相关的致命弱点,这与肿瘤增殖、血管生成和远处转移增加有关。此外,PDT 介导的氧气消耗进一步加剧了缺氧状态,最终导致药物治疗效果不佳和耐药性以及肿瘤的不可逆转转移,甚至限制了其在治疗缺氧肿瘤中的有效应用。
缺氧会导致氧气消耗增加,可能出现在肿瘤发展过程中的急性和慢性缺氧条件下。远离毛细血管的肿瘤细胞的氧气水平比相邻区域的细胞低得多。然而,通过不同的方法来降低肿瘤组织的氧气消耗,很难改变肿瘤的深部缺氧状态。因此,完全治愈恶性肿瘤将变得更加困难。近年来,许多研究集中于通过直接或间接向肿瘤组织提供分子氧来提高 PDT 治疗的疗效。在这篇综述中,从利用补充氧气的创新角度,总结了不同的分子氧补充方法来缓解肿瘤缺氧。此外,还讨论了该策略的现有问题、未来前景和潜在挑战。
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