Photodynamic
therapy (PDT) based on upconversion nanoparticles
(UCNPs) has been widely used in the treatment of a variety of tumors.
Compared with other therapeutic methods, this treatment has the advantages
of high efficiency, strong penetration, and controllable treatment
range. PDT kills tumors by generating a large amount of reactive oxygen
species (ROS), which causes oxidative stress in the tumor. However,
this killing effect is significantly inhibited by the tumor’s
own resistance to ROS. This is because tumors can either deplete ROS
by high concentration of glutathione (GSH) or stimulate autophagy
to eliminate ROS-generated damage. Furthermore, the tumor can also
consume ROS through the lactic acid metabolic pathway, ultimately
hindering therapeutic progress. To address this conundrum, we developed
a UCNP-based nanocomposite for enhanced PDT by reducing tumor ROS
resistance. First, Ce6-doped SiO2 encapsulated UCNPs to
ensure the efficient energy transfer between UCNPs and Ce6. Then,
the biodegradable tetrasulfide bond-bridged mesoporous organosilicon
(MON) was coated on the outer layer to load chloroquine (CQ) and α-cyano4-hydroxycinnamic
acid (CHCA). Finally, hyaluronic acid was utilized to modify the nanomaterials
to realize an active-targeting ability. The obtained final product
was abbreviated as UCNPs@MON@CQ/CHCA@HA. Under 980 nm laser irradiation,
upconverted red light from UCNPs excited Ce6 to produce a large amount
of singlet oxygen (1O2), thus achieving efficient
PDT. The loaded CQ and CHCA in MON achieved multichannel enhancement
of PDT. Specifically, CQ blocked the autophagy process of tumor cells,
and CHCA inhibited the uptake of lactic acid by tumor cells. In addition,
the coated MON consumed a high level of intracellular GSH. In this
way, these three functions complemented each other, just as the “three
musketeers” punctured ROS resistance in tumors from multiple
angles, and both in vitro and in vivo experiments had demonstrated
the elevated PDT efficacy of nanomaterials.