Vascular disorders, characterized
by vascular endothelial dysfunction
combined with inflammation, are correlated with numerous fatal diseases,
such as coronavirus disease-19 and atherosclerosis. Achieving vascular
normalization is an urgent problem that must be solved when treating
inflammatory vascular diseases. Inspired by the vascular regulatory
versatility of nitric oxide (NO) produced by endothelial nitric oxide
synthase (eNOS) catalyzing l-arginine (l-Arg), the
eNOS-activating effects of l-Arg, and the powerful anti-inflammatory
and eNOS-replenishing effects of budesonide (BUD), we constructed
a bi-prodrug minimalist nanoplatform co-loaded with BUD and l-Arg via polysialic acid (PSA) to form BUD-l-Arg@PSA. This
promoted vascular normalization by simultaneously regulating vascular
endothelial dysfunction and inflammation. Mediated by the special
affinity between PSA and E-selectin, which is highly expressed on
the surface of activated endothelial cells (ECs), BUD-l-Arg@PSA
selectively accumulated in activated ECs, targeted eNOS expression
and activation, and promoted NO production. Consequently, the binary
synergistic regulation of the NO/eNOS signaling pathway occurred and
improved vascular endothelial function. NO-induced nuclear factor-kappa
B alpha inhibitor (IκBα) stabilization and BUD-induced
nuclear factor-kappa B (NF-κB) response gene site occupancy
achieved dual-site blockade of the NF-κB signaling pathway,
thereby reducing the inflammatory response and inhibiting the infiltration
of inflammation-related immune cells. In a renal ischemia-reperfusion
injury mouse model, BUD-l-Arg@PSA reduced acute injury. In
an atherosclerosis mouse model, BUD-l-Arg@PSA decreased atherosclerotic
plaque burden and improved vasodilation. This represents a revolutionary
therapeutic strategy for inflammatory vascular diseases.
Immune checkpoint blockade (ICB) treatment for the clinical therapy of numerous malignancies has attracted widespread attention in recent years. Despite being a promising treatment option, developing complementary strategies to enhance the proportion of patients benefiting from ICB therapy remains a formidable challenge because of the complexity of the tumor microenvironment. Ibrutinib (IBR), a covalent inhibitor of Bruton's tyrosine kinase (BTK), has been approved as a clinical therapy for numerous B-cell malignancies. IBR also irreversibly inhibits interleukin-2 inducible T cell kinase (ITK), an essential enzyme in Th2-polarized T cells that participates in tumor immunosuppression. Ablation of ITK by IBR can elicit Th1-dominant antitumor immune responses and potentially enhance the efficacy of ICB therapy in solid tumors. However, its poor solubility and rapid clearance in vivo restrict T cell targetability and tumor accumulation by IBR. A sialic acid derivative-modified nanocomplex (SA-GA-OCT@PC) has been reported to improve the efficacy of IBR-mediated combination immunotherapy in solid tumors. In vitro and in vivo experiments showed that SA-GA-OCT@PC effectively accumulated in tumor-infiltrating T cells mediated by Siglec-E and induced Th1-dominant antitumor immune responses.
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