Oxygen switches: Refueling for cancer radiotherapy

Xianghui Li; Haoran Wang; Zhiyan Li; Feng Tao; Jinhui Wu; Wenxian Guan; Song Liu

doi:10.3389/fonc.2022.1085432

Oxygen switches: Refueling for cancer radiotherapy

Front Oncol. 2023 Feb 16:12:1085432. doi: 10.3389/fonc.2022.1085432. eCollection 2022.

Authors

Xianghui Li^{1

2

3}, Haoran Wang^{3

4}, Zhiyan Li¹, Feng Tao³, Jinhui Wu³, Wenxian Guan¹, Song Liu¹

Affiliations

¹ First Affiliated Hospital of Guangxi Medical University, Depatment of Dermatology, Nanning, China.
² Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
³ State Key Laboratory of Pharmaceutical Biotechnology, Medical School and School of Life Science, Nanjing University, Nanjing, China.
⁴ Department of Pharmacology, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China.

Abstract

Radiotherapy remains the major therapeutic intervention for tumor patients. However, the hypoxic tumor microenvironment leads to treatment resistance. Recently, a burgeoning number of nano-radiosensitizers designed to increase the oxygen concentration in tumors were reported. These nano radiosensitizers served as oxygen carriers, oxygen generators, and even sustained oxygen pumps, attracting increased research interest. In this review, we focus on the novel oxygen-enrich nano radiosensitizers, which we call oxygen switches, and highlight their influence in radiotherapy through different strategies. Physical strategies-based oxygen switches carried O₂ into the tumor via their high oxygen capacity. The chemical reactions to generate O₂ in situ were triggered by chemical strategies-based oxygen switches. Biological strategies-based oxygen switches regulated tumor metabolism, remodeled tumor vasculature, and even introduced microorganisms-mediated photosynthesis for long-lasting hypoxia alleviating. Moreover, the challenges and perspectives of oxygen switches-mediated oxygen-enrich radiotherapy were discussed.

Keywords: in-situ oxygen generation; oxygen carrier; photosynthesis; radiotherapy; tumor hypoxia.

Publication types

Review

Grants and funding

The authors acknowledge the support from the National Natural Science Foundation of China (82172645), Natural Science Foundation of Jiangsu Province (BK20200052, BK20220472), Key project of Nanjing Health Commission (ZKX21013), Bethune Charitable Foundation (05002), and Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University (2021-LCYJ-MS-09 and 2021-LCYJ-PY-17).