Materials that respond
to endogenous stimuli are being leveraged
to enhance spatiotemporal control in a range of biomedical applications
from drug delivery to diagnostic tools. The design of materials that
undergo morphological or chemical changes in response to specific
biological cues or pathologies will be an important area of research
for improving efficacies of existing therapies and imaging agents,
while also being promising for developing personalized theranostic
systems. Internal stimuli-responsive systems can be engineered across
length scales from nanometers to macroscopic and can respond to endogenous
signals such as enzymes, pH, glucose, ATP, hypoxia, redox signals,
and nucleic acids by incorporating synthetic bio-inspired moieties
or natural building blocks. This Review will summarize response mechanisms
and fabrication strategies used in internal stimuli-responsive materials
with a focus on drug delivery and imaging for a broad range of pathologies,
including cancer, diabetes, vascular disorders, inflammation, and
microbial infections. We will also discuss observed challenges, future
research directions, and clinical translation aspects of these responsive
materials.