A thrombus (blood clot), composed mainly of activated platelets and fibrin, obstructs arteries or veins, leading to various life-threatening diseases. Inspired by the distinctive physicochemical characteristics of thrombi such as abundant fibrin and an elevated level of hydrogen peroxide (HO), we developed thrombus-specific theranostic (T-FBM) nanoparticles that could provide HO-triggered photoacoustic signal amplification and serve as an antithrombotic nanomedicine. T-FBM nanoparticles were designed to target fibrin-rich thrombi and be activated by HO to generate CO bubbles to amplify the photoacoustic signal. In the phantom studies, T-FBM nanoparticles showed significant amplification of ultrasound/photoacoustic signals in a HO-triggered manner. T-FBM nanoparticles also exerted HO-activatable antioxidant, anti-inflammatory, and antiplatelet activities on endothelial cells. In mouse models of carotid arterial injury, T-FBM nanoparticles significantly enhanced the photoacoustic contrast specifically in thrombosed vessels and significantly suppressed thrombus formation. We anticipate that T-FBM nanoparticles hold great translational potential as nanotheranostics for HO-associated cardiovascular diseases.

Hydrogen peroxide (H2O2) is one of essential oxygen metabolites in living organisms, but is generated in large amounts during inflammatory responses. Therefore, H2O2 has great potential as diagnostic and therapeutic markers of several inflammatory and life‐threatening diseases. Here, chemiluminescent and antioxidant micelles are reported as novel theranostic agents for H2O2‐associated inflammatory diseases. The chemiluminescent micelles composed of amphiphilic block copolymer Pluronic F‐127, hydroxybenzyl alcohol‐incorporated copolyoxalate (HPOX) and fluorescent dyes perform peroxalate chemiluminescence reactions to detect H2O2 as low as 100 nM and image H2O2 generated in inflamed mouse ankles. The micelles encapsulating HPOX reduce the generation of reactive oxygen species in lipopolysaccharide (LPS)‐activated macrophages by scavenging overproduced H2O2 and releasing antioxidant hydroxybenzyl alcohol (HBA). They also exert inhibitory effects on H2O2‐induced apoptosis. HPOX‐based chemiluminescent and antioxidant micelles have great potential as a theranostic agent for H2O2‐associated inflammatory diseases.

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Compared to normal cells, cancer cells have a higher level of reactive oxygen species (ROS) due to aberrant metabolism and disruption of redox homeostasis which drive their proliferation and promote progression and metastasis of cancers. The altered redox balance and biological difference between normal cells and cancer cells provide a basis for the development of anticancer agents which are able to generate pharmacological ROS insults to kill cancer cells preferentially. In this study, we report a new hybrid anticancer drug, termed OSamp, which undergoes esterase- and acid-catalyzed hydrolysis to deplete antioxidant glutathione (GSH) and generate ROS, simultaneously. OSamp significantly elevated oxidative stress in cancer cells, leading to enhanced apoptotic cancer cell death through mitochondrial membrane disruption, cytochrome c release, activation of pro-caspase 3, and deactivation of STAT3 (signal transducer and activator of transcription-3). OSamp, administered intravenously, significantly suppressed the tumor growth in a mouse model of tumor xenografts without notable side effects. Oxidative stress amplifying OSamp holds tremendous potential as a new anticancer therapeutic and provides a new therapeutic paradigm which can be extended to development of hybrid anticancer drugs.

A main challenge in the development of anticancer drugs that eradicate cancer cells specifically with minimal toxicity to normal cells is to identify the cancer-specific properties. Cancer cells sustain a higher level of reactive oxygen species, owing to metabolic and signaling aberrations and unrestrained growth. Cancer cells are also furnished with a powerful reducing environment, owing to the overproduction of antioxidants such as glutathione (GSH). Therefore, the altered redox balance is probably the most prevailing property of cancer cells distinct from normal cells, which could serve as a plausible therapeutic target. In this work, we developed a GSH-depleting pro-oxidant, benzoyloxy dibenzyl carbonate, termed B2C, which is capable of rapidly declining GSH and elevating oxidative stress to a threshold level above which cancer cells cannot survive. B2C was designed to release quinone methide (QM) that rapidly depletes GSH through esterase-mediated hydrolysis. B2C was able to rapidly deplete GSH and induce an overwhelming level of oxidative stress in cancer cells, leading to mitochondrial disruption, activation of procaspase-3 and PARP-1, and cleavage of Bcl-2. In the study of tumor xenograft models, intravenously injected B2C caused apoptotic cell death in tumors and significantly suppressed tumor growth. These findings provide a new insight into the design of more effective anticancer drugs, which exploit altered redox balance in cancer cells.

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