Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao 266021, China; Department of Cardiovascular Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao 266003, China.
Department of Radiotherapy, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao 266021, China.
J Control Release. 2023 Sep;361:547-567. doi: 10.1016/j.jconrel.2023.08.003. Epub 2023 Aug 15.
Sonodynamic therapy (SDT) has gained significant attention in the treatment of deep tumors and multidrug-resistant (MDR) bacterial infections due to its high tissue penetration depth, high spatiotemporal selectivity, and noninvasive therapeutic method. SDT combines low-intensity ultrasound (US) and sonosensitizers to produce lethal reactive oxygen species (ROS) and external damage, which is the main mechanism behind this therapy. However, traditional organic small-molecule sonosensitizers display poor water solubility, strong phototoxicity, and insufficient targeting ability. Inorganic sonosensitizers, on the other hand, have low ROS yield and poor biocompatibility. These drawbacks have hindered SDT's clinical transformation and application. Hence, designing stimuli-responsive nano-sonosensitizers that make use of the lesion's local microenvironment characteristics and US stimulation is an excellent alternative for achieving efficient, specific, and safe treatment. In this review, we provide a comprehensive overview of the currently accepted mechanisms in SDT and discuss the application of responsive nano-sonosensitizers in the treatment of tumor and bacterial infections. Additionally, we emphasize the significance of the principle and process of response, based on the classification of response patterns. Finally, this review emphasizes the potential limitations and future perspectives of SDT that need to be addressed to promote its clinical transformation.
声动力学疗法（SDT）由于其具有较高的组织穿透深度、较高的时空选择性和非侵入性的治疗方法，在治疗深部肿瘤和多药耐药（MDR）细菌感染方面引起了广泛关注。SDT 将低强度超声（US）与声敏剂结合使用，产生致命的活性氧（ROS）和外部损伤，这是该疗法的主要机制。然而，传统的有机小分子声敏剂显示出较差的水溶性、强的光毒性和不足的靶向能力。相比之下，无机声敏剂的 ROS 产率低，生物相容性差。这些缺点阻碍了 SDT 的临床转化和应用。因此，设计利用病变局部微环境特征和超声刺激的响应性纳米声敏剂是实现高效、特异、安全治疗的一种很好的替代方法。在这篇综述中，我们全面概述了 SDT 的当前公认机制，并讨论了响应性纳米声敏剂在肿瘤和细菌感染治疗中的应用。此外，我们根据响应模式的分类，强调了响应的原理和过程的重要性。最后，本文强调了需要解决的 SDT 的潜在局限性和未来展望，以促进其临床转化。
