Modulating glucose metabolism and relieving hypoxia for enhanced Chemo/Photoimmunotherapy with photosensitizing enzymatic nanodrugs

Abstract

Photoimmunotherapy by photodynamic therapy (PDT) induces immunogenic cell death (ICD), providing anti-tumor treatment in a safe, precise, minimally invasive way. However, PDT-demanded massive oxygen consumption exacerbates the hypoxia and creates an acidic tumor microenvironment (TME), leading to an anaerobic glycolysis and immune escape condition. In this study, a natural anti-tumor resveratrol (RSV) nanodrug was introduced via Fe3+ coordination flash nanoprecipitation (cFNP) for enhanced aqueous solubility to specifically downregulate the expression of Pyruvate kinase M2 (PKM2) and lactate dehydrogenase A (LDHA), reduce the glucose resorption and lactate production, tipping the cellular balance from anaerobic glycolysis to oxidative phosphorylation (OXPHOS). RSV enhances the immunotherapy by suppressing tumor cell glycolysis and active the apoptotic cell death as well. Meanwhile, structural linker Fe3+ could also effectively catalyze the endogenous H2O2 in the tumor cells to generate oxygen in situ and relieve the hypoxic microenvironment, enhancing the PDT efficacy. This strategy can effectively modulate glucose metabolism and relieve hypoxia by Fe/RSV/ZnPc nanodrugs to greatly promote the synergistic chemo/photoimmunotherapy, providing a promising strategy to tackle the formulation of multi-therapeutic nanodrugs for clinical cancer therapy.