E-mail: xiesonglin Sonodynamic therapy SDT is a novel non-invasive treatment for cancer combining low-intensity ultrasound and sonosensitizers. SDT activates sonosensitizers through ultrasound, releasing energy and generating reactive oxygen species to kill tumor cells. Compared with traditional photodynamic therapy PDT , SDT is a promising anti-cancer therapy with the advantages of better targeting, deeper tissue penetration, and higher focusing ability.
With the development and broad application of nanomaterials, novel sonosensitizers with tumor-targeting specificity can deliver to deep tumors and enhance the tumor microenvironment. In this review, we first review the mechanisms of sonodynamic therapy. In addition, we also focus on the current types of sonosensitizers and the latest design strategies of nanomaterials in sonosensitizers. Finally, we summarize the combined strategy of sonodynamic therapy. Current studies have shown that the mechanisms of sonodynamic therapy for tumor treatment are ultrasound cavitation effect, ultrasound thermal effect, oxygen radical theory, apoptosis, autophagy, and the combination of the above mechanisms.
Sonosensitizers are an integral part of the SDT process. Sonosensitizers convert acoustic energy into chemical energy through special chemical structures to generate ROS to complete SDT. Therefore, the performance of the sonosensitizer can significantly affect the efficiency of SDT. The ideal sonosensitizer should have good biocompatibility, high bioavailability, and precise tumor targeting.
Due to the complex growth mechanism of tumors, it is difficult to achieve the best therapeutic effect with a single treatment method. Combining SDT with other cancer treatments shows excellent potential. For example, SDT combined with photodynamic therapy PDT , chemotherapy, immunotherapy, and photothermal therapy PTT can achieve significant synergistic therapeutic effects.
Previous reviews have focused on introducing the mechanism of SDT and a brief review of sonosensitizers, did not focus on the application of SDT in nanomaterials, and failed to summarize the application of SDT in combined tumor therapy.
