The promise of low-intensity ultrasound: A review on sonosensitizers and sonocatalysts by ultrasonic activation for bacterial killing

Breaking Barriers in Oncology: Harnessing Sonodynamic Therapy for Enhanced Tumor Metabolism Regulation

The recent booming development of sonometabolism regulation in controlling the tumor microenvironment (TME) has opened a new research area to identify innovative approaches against cancer. The aim of this review is to highlight the potentials and advantages of sonodynamic therapy (SDT) in antitumor nanotherapies, specifically, delineating the progress made in SDT concerning the regulation of TME metabolism which encompasses factors such as hypoxia, redox balance, autophagy, immunosuppression, ion homeostasis, and other metabolic processes. By focusing on both tumor cell metabolism and TME dynamics, a wide range of SDT strategies that have demonstrated great therapeutic effectiveness by targeting the metabolic functions inherent to TME are summarized. In conclusion, this review offers valuable insights for researchers involved in SDT-based antitumor therapeutic strategies, with the aim of advancing the development of antitumor SDT methodologies in future research.

Emerging synergistic strategies for enhanced antibacterial sonodynamic therapy: Advances and prospects

Antibacterial therapy has been extensively applied in medical field to alleviate the severity and mortality of infection. However, it still exists some issues such as drug side effects, limited efficacy and bacterial resistance. Among the alternative therapies, antibacterial sonodynamic therapy (aSDT) has been explored as a promising approach to tackle those crises. It is meaningful to investigate superior strategy to augment the therapeutic efficacy of aSDT. This review summarizes the potential aSDT-based antibacterial mechanisms and comprehensively discusses the prevailing synergistic strategies, such as nanomaterials-based aSDT antibacterial strategy, aSDT + strategy with physical, chemical and biological methods. Moreover, we also reviewed the medical applications of aSDT strategies. Finally, the perspectives on the current challenges that need be resolved in aSDT are proposed. We expect that this review could provide robust support to expedite the clinical applications of aSDT.

Nanosensitizer-assisted sonodynamic therapy for breast cancer

Breast cancer is the most commonly diagnosed cancer worldwide. Despite advancements in therapeutic modalities, its prognosis remains poor owing to complex clinical, pathological, and molecular characteristics. Sonodynamic therapy (SDT) is a promising approach for tumor elimination, using sonosensitizers that preferentially accumulate in tumor tissues and are activated by low-intensity ultrasound to produce reactive oxygen species. However, the clinical translation of SDT faces challenges, including the limited efficiency of sonosensitizers and resistance posed by the tumor microenvironment. The emergence of nanomedicine offers innovative strategies to address these obstacles. This review discusses strategies for enhancing the efficacy of SDT using sonosensitizers, including rational structural modifications, improved tumor-targeted enrichment, tumor microenvironment remodeling, and imaging-guided therapy. Additionally, SDT-based multimodal therapies, such as sono-chemotherapy, sono-immunotherapy, and sono-photodynamic therapy, and their potential applications in breast cancer treatment are summarized. The underlying mechanisms of SDT in breast cancer are briefly outlined. Finally, this review highlights current challenges and prospects for the clinical translation of SDT, providing insights into future advancements that may improve therapeutic outcomes for breast cancer.

Antibacterial sonodynamic nanomedicine: mechanism, category, and applications

Sonodynamic therapy (SDT) has emerged as a cutting-edge strategy for combating multidrug-resistant bacterial infections. Unlike conventional antibiotics, SDT leverages the generation of reactive oxygen species during the treatment process to inflict multifaceted damage on bacterial cells, thereby significantly reducing the likelihood of developing drug resistance. Compared to other physical sterilisation methods, such as ultraviolet irradiation, SDT offers enhanced tissue penetration, making it particularly suitable for addressing deep-seated infections, including osteomyelitis. Despite its significant advantages, the clinical translation of SDT for antibacterial applications faces several challenges. This review discusses the fundamental mechanisms of SDT, with a focus on phenomena such as cavitation-induced reactions and piezocatalytic generation of reactive oxygen species. Furthermore, it provides a comprehensive analysis of various sonosensitisers used in SDT, emphasising their potential to enhance therapeutic outcomes in areas such as infected wound healing, bone regeneration, and the mitigation of deep tissue inflammation. While SDT shows great promise in addressing multidrug-resistant bacterial infections, further research and development are essential to overcome existing limitations and unlock its full clinical potential.

Ultrasound and glutathione dual-responsive biomimetic nanoplatform for ultrasound/magnetic resonance imaging and sonodynamic therapy of ovarian cancer

Sonodynamic therapy (SDT) has emerged as a promising treatment method for unresectable ovarian cancer (OC) due to its deeper permeability and absence of phototoxicity. However, the low targeting efficiency of sonosensitizers and the hypoxic tumor environment limit the efficacy of SDT, posing significant challenges to tumor treatment. Herein, an ultrasound (US) and glutathione (GSH) dual-responsive SDT nanoplatform, AIPH-MSTN@BSA-MnO2@CCM (AMBC) was prepared by loading O2 generator MnO2 nanoparticles (NPs) and alkyl radical generator 2,2-azobis [2-(2-imidazoline-2-yl) propane] dihydrochloride (AIPH) into porous SiO2 grown with TiO2 NPs (MSTN), followed by coating with OC cell membrane (CCM). The MnO2 not only can be reduced by GSH to Mn2+ for T1-weighted magnetic resonance (MR) imaging but also catalyzes the decomposition of endogenous H2O2, providing sufficient O2 for the production of reactive oxygen species (ROS) induced by TiO2. Under the action of US, AIPH decomposes to produce alkyl radicals and N2, which further enhances the acoustic cavitation effect of TiO2 and promotes the production of ROS and enhances US imaging. In addition, CCM, with its homologous targeting and immune escape properties, enables AMBC to be targeted and delivered to tumor cells. Together, this work constructs a novel sonodynamic nanoplatform with homologous targeting and superior hypoxia-overcoming ability for efficient SDT of OC, guided by US/MR dual-mode imaging.

Self-Assembled PVP-Gd Composite Nanosheets via Ultrasound Synthesis for Targeted Acrylamide Sensing in Food Safety

Acrylamide (AM) is a recognized carcinogen and neurotoxin, posing a significant threat to food safety and human health. Therefore, developing sensitive and convenient methods for AM detection in food samples is essential. This study responds to the urgent need for sensitive and selective detection of AM, a hidden hazard in food, to safeguard public health and environmental safety. We present the development of a novel two-dimensional ultrasound-synthesized PVP-Gd composite nanosheet platform for precise AM sensing. These self-assembled nanosheets, constructed from gadolinium (Gd) and poly(vinylpyrrolidone) (PVP), exhibit remarkable stability and robust blue fluorescence, with a quantum yield of 45.01% upon excitation at 380 nm. A full factorial design was employed to optimize the synthesis process, revealing significant parameter interactions. The optimized nanosheets demonstrated a strong quenching effect upon acrylamide exposure, resulting in a high-performance acrylamide sensor with an impressively low detection limit (9.4 nM) and a broad linear response range. This innovative sensor platform offers a promising approach for environmental monitoring and food safety applications, effectively addressing the risks associated with acrylamide.

Dominant spoilage bacteria in crayfish alleviate ultrasonic stress through mechanosensitive channels but could not prevent the process of membrane destruction

Although there have been many studies on the efficacy of ultrasonic inactivation, the stress resistance mechanism of bacteria is still a challenge for complete ultrasonic inactivation. In this study, the dominant spoilage bacteria in crayfish, Shewanella baltica (S. baltica) and Aeromonas veronii (A. veronii), were subjected to high-intensity ultrasonic treatment. The results showed compromised cell membrane, decreased membrane fluidity, hyperpolarized membrane potential, and disrupted succinate-coenzyme Q reductase. Transmission electron microscopy revealed significant fragmentation of S. baltica, whereas A. veronii, with its thick cell wall and outer capsule membrane, demonstrated enhanced resistance to ultrasound. Real-time quantitative PCR indicated that in response to ultrasonic stress, bacteria initiated a stress response mechanism by increasing the expression of mechanosensitive channels; meanwhile, the outer capsule of A. veronii delayed the transformation of ultrasonic external forces into cell membrane stress. The study found that in response to ultrasonic stress, bacteria initiated a stress response mechanism by increasing the expression of mechanosensitive channels as "emergency valve" in short time but could not prevent the process of membrane destruction with prolonged exposure. This finding provided a basis for addressing bacterial stress tolerance in ultrasonic inactivation.

Multifaceted role of nanocomposite hydrogels in diabetic wound healing: enhanced biomedical applications and detailed molecular mechanisms

The complex microenvironment of diabetic wounds, which is characterized by persistent hyperglycemia, excessive inflammatory responses, and hypoxic conditions, significantly impedes the efficacy of traditional hydrogels. Nanocomposite hydrogels, which combine the high-water content and biocompatibility of hydrogels with the unique functionalities of nanomaterials, offer a promising solution. These hydrogels exhibit enhanced antibacterial, antioxidant, and drug-release properties. Incorporating nanomaterials increases the mechanical strength and bioactivity of hydrogels, allowing for dynamic regulation of the wound microenvironment and promoting cell migration, proliferation, and angiogenesis, thereby accelerating wound healing. This review provides a comprehensive overview of the latest advances in nanocomposite hydrogels for diabetic wound treatment and discusses their advantages and molecular mechanisms at various healing stages. The study aims to provide a theoretical foundation and practical guidance for future research and clinical applications. Furthermore, it highlights the challenges related to the mechanical durability, antimicrobial performance, resistance issues, and interactions with the cellular environments of these hydrogels. Future directions include optimizing smart drug delivery systems and personalized medical approaches to enhance the clinical applicability of nanocomposite hydrogels.

Smart drug delivery and responsive microneedles for wound healing

Wound healing is an ongoing concern for the medical community. The limitations of traditional dressings are being addressed by materials and manufacturing technology. Microneedles (MNs) are a novel type of drug delivery system that has been widely used in cancer therapy, dermatological treatment, and insulin and vaccine delivery. MNs locally penetrate necrotic tissue, eschar, biofilm and epidermis into deep tissues, avoiding the possibility of drug dilution and degradation and greatly improving administration efficiency with less pain. MNs represent a new direction for wound treatment and transdermal delivery. In this study, we summarise the skin wound healing process and the mechanical stimulation of MNs in the context of the wound healing process. We also introduce the structural design and manufacture of MNs. Subsequently, MNs are categorised according to the loaded drugs, where the design of the MNs according to the traumatic biological/biochemical microenvironment (pH, glucose, and bacteria) and the physical microenvironment (temperature, light, and ultrasound) is emphasised. Finally, the advantages of MNs are compared with traditional drug delivery systems and their prospects are discussed.

2D spatiotemporal passive cavitation imaging and evaluation during ultrasound thrombolysis based on diagnostic ultrasound platform

Acoustic cavitation plays a critical role in various biomedical applications. However, uncontrolled cavitation can lead to undesired damage to healthy tissues. Therefore, real-time monitoring and quantitative evaluation of cavitation dynamics is essential for understanding underlying mechanisms and optimizing ultrasound treatment efficiency and safety. The current research addressed the limitations of traditionally used cavitation detection methods by developing introduced an adaptive time-division multiplexing passive cavitation imaging (PCI) system integrated into a commercial diagnostic ultrasound platform. This new method combined real-time cavitation monitoring with B-mode imaging, allowing for simultaneous visualization of treatment progress and 2D quantitative evaluation of cavitation dosage within targeted area. An improved delay-and-sum (DAS) algorithm, optimized with a minimum variance (MV) beamformer, is utilized to minimize the side lobe effect and improve the axial resolution typically associated with PCI. In additional to visualize and quantitatively assess the cavitation activities generated under varied acoustic pressures and microbubble concentrations, this system was specifically applied to perform 2D cavitation evaluation for ultrasound thrombolysis mediated by different solutions, e.g., saline, nanodiamond (ND) and nitrogen-annealed nanodiamond (N-AND). This research aims to bridge the gap between laboratory-based research systems and real-time spatiotemporal cavitation evaluation demands in practical uses. Results indicate that this improved 2D cavitation monitoring and evaluation system could offer a useful tool for comprehensive evaluating cavitation-mediated effects (e.g., ultrasound thrombolysis), providing valuable insights into in-depth understanding of cavitation mechanisms and optimization of cavitation applications.

Designed Nanodrugs for Ultrasonic Removal of Toxic Polyglutamine Aggregates from Neuron Cells

Clearing of toxic polyglutamine aggregates from neuronal cells is crucial for ameliorating Huntington's disease. However, such clearance is challenging, requiring the targeting of affected neuron cells in the brain, followed by the removal of polyglutamine from cells. Here we report a designed nanodrug that can be used for the ultrasound-based removal of toxic polyglutamine aggregates from neuron cells. The nanodrug is composed of a sonosensitizer molecule, chlorin e6- or protoporphyrin IX-loaded polymer micelle of 20-30 nm in size that rapidly delivers the sonosensitizer into the cell nucleus. Ultrasound exposure of these cells generates singlet oxygen in the nucleus/perinuclear region that induces strong autophagic flux and clears toxic polyglutamine aggregates from cells. It has been demonstrated that the nanodrug and ultrasound treatment can enhance the cell survival against polyglutamine aggregates by 4 times. This result suggests that the nanodrug can be designed for focused ultrasound-based wireless treatment of various neurodegenerative diseases.

The Evolution of Sonochemistry: From the Beginnings to Novel Applications

Sonochemistry is the use of ultrasonic waves in an aqueous medium, to generate acoustic cavitation. In this context, sonochemistry emerged as a focal point over the past few decades, starting as a manageable process such as a cleaning technique. Now, it is found in a wide range of applications across various chemical, physical, and biological processes, creating opportunities for analysis between these processes. Sonochemistry is a powerful and eco-friendly technique often called "green chemistry" for less energy use, toxic reagents, and residues generation. It is increasing the number of applications achieved through the ultrasonic irradiation (USI) method. Sonochemistry has been established as a sustainable and cost-effective alternative compared to traditional industrial methods. It promotes scientific and social well-being, offering non-destructive advantages, including rapid processes, improved process efficiency, enhanced product quality, and, in some cases, the retention of key product characteristics. This versatile technology has significantly contributed to the food industry, materials technology, environmental remediation, and biological research. This review is created with enthusiasm and focus on shedding light on the manifold applications of sonochemistry. It delves into this technique's evolution and current applications in cleaning, environmental remediation, microfluidic, biological, and medical fields. The purpose is to show the physicochemical effects and characteristics of acoustic cavitation in different processes across various fields and to demonstrate the extending application reach of sonochemistry. Also to provide insights into the prospects of this versatile technique and demonstrating that sonochemistry is an adapting system able to generate more efficient products or processes.

Application of antimicrobial sonodynamic therapy as a potential treatment modality in dentistry: A literature review

The accumulation of dental plaque is a precursor to various dental infections, including lesions, inflammation around dental implants, and inflammation under dentures. Traditional cleaning methods involving physical removal and chemical agents often fall short of eliminating bacteria and their protective biofilms. These methods can also inadvertently lead to bacteria that resist drugs and upset the mouth's microbial harmony. To counter these issues, a new approach is needed that can target and clear away dental plaque, minimize biofilms and bacteria, and thus support sustained dental health. Enter antimicrobial sonodynamic therapy (aSDT), a supplementary treatment that uses gentle ultrasound waves to trigger a sonosensitizer compound, destroying bacterial cells. This process works by generating heat, mechanical pressure, initiating chemical reactions, and producing reactive oxygen species (ROS), offering a fresh tactic for managing dental plaque and biofilms. The study reviews how aSDT could serve as an innovative dental treatment option to enhance oral health.

Harvesting Vibration Energy for Efficient Cocatalyst-Free Sonocatalytic H2 Production over Magnetically Separable Ultra-Low-Cost Fe3O4

The cavitation effect is an important geochemical phenomenon, which generally exists under strong hydrodynamic conditions. Therefore, developing an economical and effective sonocatalyst becomes a vital method in capitalizing on the cavitation effect for energy generation. In this study, we first report a novel Fe3O4 sonocatalyst that can be easily separated using a magnetic field and does not require any additional cocatalysts for H2 production from H2O. When subjected to ultrasonic vibration, this catalyst achieves an impressive H2 production rate of up to 175 μmol/h/USD (where USD stands for dollars), surpassing most previously reported mechanical catalytic materials. Furthermore, the ease and efficiency of separating this catalyst using an external magnetic field, coupled with its effortless recovery, highlight its significant potential for practical applications. By addressing the key limitations of conventional sonocatalysts, our study not only demonstrates the feasibility of using Fe3O4 as a highly efficient sonocatalyst but also showcases the exciting possibility of using a new class of magnetically separable sonocatalysts to productively transform mechanical energy into chemical energy.

Conjugated polymer nanoparticles as sonosensitizers in sono-inactivation of a broad spectrum of pathogens

Sonodynamic inactivation (SDI) of pathogens has an important advantage when compared to optical excitation-based protocols due to the deeper penetration of ultrasound (US) excitation in biological media or animal tissue. Sonosensitizers (SS) are compounds or systems that upon US stimulation in the therapeutic window (frequency = 0.8-3 MHz and intensity < 3 W/cm2) can induce damage to vital components of pathogenic microorganisms. Herein, we report the synthesis and application of conjugated polymer nanoparticles (CPNs) as an efficient SS in SDI of methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae and Candida tropicalis. A frequent problem in the design and testing of new SS for SDI is the lack of proper sonoreactor characterization which leads to reproducibility concerns. To address this issue, we performed dosimetry experiments in our setup. This enables the validation of our results by other researchers and facilitates meaningful comparisons with different SDI systems in future studies. On a different note, it is generally accepted that the mechanisms of action underlying SS-mediated SDI involve the production of reactive oxygen species (ROS). In an attempt to establish the nature of the cytotoxic species involved in our CPNs-based SDI protocol, we demonstrated that singlet oxygen (1O2) does not play a major role in the observed sonoinduced killing effect. SDI experiments in planktonic cultures of optimally growing pathogens using CPNs result in a germicide effect on the studied pathogenic microorganisms. The implementation of SDI protocols using CPNs was further tested in mature biofilms of a MRSA resulting in ∼40 % reduction of biomass and ∼70 % reduction of cellular viability. Overall, these results highlight the unique and unexplored capacity of CPNs to act as sonosensitizers opening new possibilities in the design and application of novel inactivation protocols against morbific microbes.

X-ray and UV Irradiation-Induced Reactive Oxygen Species Mediated Antibacterial Activity in Fe and Pt Nanoparticle-Decorated Si-Doped TiCaCON Films

Bone implants with biocompatibility and the ability to biomineralize and suppress infection are in high demand. The occurrence of early infections after implant placement often leads to repeated surgical treatment due to the ineffectiveness of antibiotic therapy. Therefore, an extremely attractive solution to this problem would be the ability to initiate bacterial protection of the implant by an external influence. Here, we present a proof-of-concept study based on the generation of reactive oxygen species (ROS) by the implant surface in response to X-ray irradiation, including through a layer of 3 mm adipose tissue, providing bactericidal protection. The effect of UV and X-ray irradiation of the implant surface on the ROS formation and the associated bactericidal activity was compared. The focus of our study was light-sensitive Si-doped TiCaCON films decorated with Fe and Pt nanoparticles (NPs) with photoinduced antibacterial activity mediated by ROS. In the visible and infrared range of 300-1600 nm, the films absorb more than 60% of the incident light. The high light absorption capacity of TiO2/TiC and TiO2/TiN heterostructures was demonstrated by density functional theory calculations. After short-term (5-10 s) low-dose X-ray irradiation, the films generated significantly more ROS than after UV illumination for 1 h. The Fe/TiCaCON-Si films showed enhanced biomineralization capacity, superior cytocompatibility, and excellent antibacterial activity against multidrug-resistant hospital Escherichia coli U20 and K261 strains and methicillin-resistant Staphylococcus aureus MW2 strain. Our study clearly demonstrates that oxidized Fe NPs are a promising alternative to the widely used Ag NPs in antibacterial coatings, and X-rays can potentially be used in ROS-regulating therapy to suppress inflammation in case of postimplant complications.

Photo- and Sono-Active Food Colorants Inactivating Bacteria

Food colorants are commonly used as excipients in pharmaceutical and nutraceutical fields, but they have a wide range of other potential applications, for instance, as cytotoxic drugs or mediators of physical antimicrobial treatments. The photodynamic antibacterial activity of several edible food colorants is reported here, including E127, E129, E124, E122, E133, and E150a, alongside Rhein, a natural lipophilic antibacterial and anticancer compound found in medicinal plants. Minimal inhibitory concentration (MIC) values for S. aureus and E. coli showed that E127 and Rhein were effective against both bacteria, while other colorants exhibited low activity against E. coli. In some cases, dark pre-incubation of the colorants with Gram-positive S. aureus increased their photodynamic activity. Adding Rhein to E127 increased the photodynamic activity of the latter in a supportive mode. Optional sensing mechanism pathways of combined E127/Rhein action were suggested. The antibacterial activity of the studied colorants can be ranged as follows: E127/Rhein >> E127 >> E150a > E122 > E124 >> E129 ≈ E133. E127 was also found to exhibit photodynamic properties. Short ultrasonic treatment before illumination caused intensification of E127 photodynamic activity against E. coli when applied alone and especially in combination with Rhein. Food colorants exhibiting photo- and sonodynamic properties may have good potential in food preservation.

Inorganic Sonosensitizers for Sonodynamic Therapy in Cancer Treatment

The rapid development of nanomedicine and nanobiotechnology has allowed the emergence of various therapeutic modalities with excellent therapeutic efficiency and biosafety, among which, the sonodynamic therapy (SDT), a combination of low-intensity ultrasound and sonosensitizers, is emerging as a promising noninvasive treatment modality for cancer treatment due to its deeper penetration, good patient compliance, and minimal damage to normal tissue. The sonosensitizers are indispensable components in the SDT process because their structure and physicochemical properties are decisive for therapeutic efficacy. Compared to the conventional and mostly studied organic sonosensitizers, inorganic sonosensitizers (noble metal-based, transition metal-based, carbon-based, and silicon-based sonosensitizers) display excellent stability, controllable morphology, and multifunctionality, which greatly expand their application in SDT. In this review, the possible mechanisms of SDT including the cavitation effect and reactive oxygen species generation are briefly discussed. Then, the recent advances in inorganic sonosensitizers are systematically summarized and their formulations and antitumor effects, particularly highlighting the strategies for optimizing the therapeutic efficiency, are outlined. The challenges and future perspectives for developing state-of-the-art sonosensitizers are also discussed. It is expected that this review will shed some light on future screening of decent inorganic sonosensitizers for SDT.

Defect-Modified nano-BaTiO3 as a Sonosensitizer for Rapid and High-Efficiency Sonodynamic Sterilization

Multidrug-resistant bacteria caused by the unlimited overuse of antibiotics pose a great challenge to global health. An antibacterial method based on reactive oxygen species (ROS) is one of the effective strategies without inducing bacterial resistance. Owing to the ability of generating ROS, piezocatalytic material-mediated sonodynamic therapy (SDT) has drawn much attention. However, its major challenge is the low ROS generation efficiency in the piezocatalytic process due to the poor charge carrier concentration of piezoelectric materials. Vacancy engineering can regulate the charge density and largely promote ROS generation under ultrasound (US) irradiation. Herein, a US-responsive self-doped barium titanate with controlled oxygen vacancy (Vo) concentrations was successfully synthesized through a facile thermal reduction treatment at different temperatures (i.e., 350, 400, and 450 °C), and the corresponding samples were named as BTO-350, BTO-400, and BTO-450, respectively. Then, the effect of Vo concentrations on ROS generation efficiency during the piezocatalytic process was systematically studied. And BTO-400 was found to possess the highest piezocatalytic activity and excellent sonodynamic antibacterial performance against Escherichia coli and Staphylococcus aureus. Furthermore, its antibacterial mechanism was confirmed that the ROS generated under US could damage bacterial cell membrane and cause considerable leakage of cytoplasmic components and irreversible death of bacteria. Notably, the in vivo results illustrated that the BTO-400 could serve as an effective antibacterial agent and accelerate skin healing via SDT therapy. In all, the Vo defect-modified nano-BaTiO₃ has a noticeable potential to induce a rapid and efficient sterilization as well as skin tissue repair by SDT.

Ultrasound activatable microneedles for bilaterally augmented sono-chemodynamic and sonothermal antibacterial therapy

Chemodynamic therapy (CDT) employs Fenton catalysts to kill bacteria by converting hydrogen peroxide (H₂O₂) into toxic hydroxyl radical (•OH). Among them, Fenton-type metal peroxide nanoparticles fascinate nanomaterials with intriguing physiochemical properties, but research on this antibacterial agent is still in its infancy. Herein, a distinct CuO₂/TiO₂ heterostructure constituted of ultrasmall copper peroxide (CuO₂) nanoclusters and sonosensitized ultrathin oxygen vacancy-rich porous titanium oxide (OV-TiO₂) nanosheets was developed and was incorporated into microneedles for bilaterally augmented sono-chemodynamic and sonothermal antibacterial therapy. Engineering CuO₂ nanoclusters on the surface of TiO₂ nanosheets not only endows the Fenton catalytic activity for sono-chemodynamic therapy (SCDT), but also improves the sonodynamic and sonothermal performance of TiO₂ by narrowing the bandgap of TiO₂ and suppressing the recombination of electron-hole pairs. The high efficacy of this CuO₂/TiO₂ integrated microneedle (CTMN) patch was systematically demonstrated both in vitro and in vivo with the eliminating rate >99.9999% against multidrug resistant (MDR) pathogens in 5 min as well as accelerated wound tissue healing. This work highlights a promisingly new and efficient strategy for the development of sonosensitive and chemoreactive nanomedicine for non-antibiotic therapies. STATEMENT OF SIGNIFICANCE: Feton-type metal peroxides, a novel nanomaterial with self-supplied oxygen and hydrogen peroxide, can achieve effective antimicrobial activity in vitro. However, there is a lack of effective nanomaterial delivery systems and suitable means for in vivo activation/enhancement of antimicrobial activity during bacterial infected skin wound treatment. In this study, we designed and prepared efficient ultrasound activable microneedles that effectively addressed the deficiencies mentioned above and established a new paradigm for efficient utilization of metal peroxide nanomaterials and ultrasound based strategies. Noticeably, copper peroxide nanoclusters/oxygen vacancy-rich porous titanium oxide nanosheets (CuO₂/TiO₂) integrated microneedle (CTMN) patch combines advantages of both sono-chemodynamic and sonothermal antibacterial therapy, achieving one of the most instant and effective antibacterial efficacy (>99.9999% in 5 min) in vivo reported till now.

Newly developed gas-assisted sonodynamic therapy in cancer treatment

Sonodynamic therapy (SDT) is an emerging noninvasive treatment modality that utilizes low-frequency and low-intensity ultrasound (US) to trigger sensitizers to kill tumor cells with reactive oxygen species (ROS). Although SDT has attracted much attention for its properties including high tumor specificity and deep tissue penetration, its anticancer efficacy is still far from satisfactory. As a result, new strategies such as gas-assisted therapy have been proposed to further promote the effectiveness of SDT. In this review, the mechanisms of SDT and gas-assisted SDT are first summarized. Then, the applications of gas-assisted SDT for cancer therapy are introduced and categorized by gas types. Next, therapeutic systems for SDT that can realize real-time imaging are further presented. Finally, the challenges and perspectives of gas-assisted SDT for future clinical applications are discussed.

Application of sonodynamic technology and sonosensitizers in food sterilization: a review of developments, trends and challenges

Food safety and food waste have always been hot topics of discussion in recent years. However, the infection of human pathogenic bacteria and the waste of food resources caused by microbial-contaminated food remains common. Although traditional sterilization technology has been very mature, it causes changes in food flavor and excessive energy consumption to a certain extent. Moreover, the widespread bacterial resistance has also sounded a warning for researchers and finding a new alternative to antibiotics is urgently needed. The application of sonodynamic sterilization technology in medical treatment has aroused the interest of researchers. It provides ideas for new food sterilization technology. As a new non-thermal sterilization technology, sonodynamic sterilization technology has strong penetration, safety, less residue and by-products, and will less change the quality of the food itself. Therefore, sonodynamic sterilization technology has great potential applied in food sterilization technology. This review describes the concept of sonodynamic sterilization technology, the sterilization mechanism of sonodynamic sterilization and the inactivation mechanism of various pathogens, the classification and application of sonosensitizers, and the ultrasonic technology in sonodynamic sterilization in the application over the recent years. It provides a scientific reference for the application of sonodynamic sterilization technology in the field of food sterilization.