Imaging-guided
percutaneous microwave thermotherapy has been regarded
as an important alternative nonsurgical therapeutic strategy for hepatocellular
carcinoma (HCC) that provides excellent local tumor control and favorable
survival benefit. However, providing a high-resolution, real-time,
and noninvasive imaging technique for intraoperative guidance and
controlling postoperative residual tumor recurrence are urgent needs
for the clinical setting. In this study, a cisplatin (CDDP)-loaded
nanocapsule (NPs@CDDP) with microwave responsive property was prepared
to simultaneously serve as a contrast agent of emerging thermoacoustic
imaging and a sensitizing agent of microwave thermo-chemotherapy.
Accompanying the enzymolysis in the tumor microenvironment, the NPs@CDDP
responsively release l-arginine (l-Arg) and CDDP. l-Arg with excellent microwave-absorbing property allowed it
to serve as a thermoacoustic imaging contrast agent for accurately
delineating the tumor and remarkably increasing tumor temperature
under ultralow power microwave irradiation. Apart from the chemotherapeutic
effect, CDDP elevated the intracellular H2O2 level through cascade reactions and further accelerated the continuous
transformation of l-Arg to nitric oxide (NO), which endowed
the NPs@CDDP with NO-generation capability. Notably, the high concentration
of intracellular NO was proved to aggravate lipid peroxidation and
greatly improved the efficacy of microwave thermo-chemotherapy. Thereby,
NPs@CDDP was expected to serve as a theranostic agent integrating
the functions of tumor microenvironment-responsive drug delivery system,
contrast agent of thermoacoustic imaging, thermal sensitizing agent,
and NO nanogenerator, which was promising to provide a potential imaging-guided
therapeutic strategy for HCC.