奈米催化醫學：化學動力治療

化學動力治療（chemodynamic therapy, CDT）是一種新興的腫瘤治療手段，可通過奈米催化體系，將內源性化學能轉換成具有細胞殺傷性活性氧物質，從而抑制腫瘤生長。鐵、銅、錳等過渡金屬，是常見的催化中心位點，可藉由腫瘤微環境弱酸性和H_2O_2過量等特點，通過芬頓或類芬頓反應，催化H_2O_2生成OH，引起腫瘤細胞氧化損傷並誘導細胞凋亡。由於CDT具有腫瘤特異性高，不需要外源能量輸入等優點，可用於深部腫瘤治療，擁有良好的應用前景。儘管如此，現階段CDT治療效率並不理想，尚未有臨床試驗進行。本文除回顧近年來相關研究發展，說明CDT的重要機理外，也將從發展高效能奈米催化劑、改善腫瘤微環境，以及聯合其他治療方法的三個面向，闡述CDT治療局限性和效率提升的重要發展方向，並針對未來研究趨勢進行展望。

關鍵字

化學動力治療；芬頓／類芬頓反應；奈米催化劑；腫瘤微環境；聯合療法

並列摘要

Chemodynamic therapy (CDT) is an emerging tumor treatment modality that utilizes nanocatalysts to convert endogenous chemical energy into harmful reactive oxygen species. Transition metals such as iron, copper, and manganese are common catalytic centers. Due to the over-expression of H_2O_2 in the acidic tumor microenvironment, they can catalyze H_2O_2 to generate OH through Fenton or Fenton-like reactions, causing potent oxidative damage and inducing tumor cell apoptosis. CDT is therefore considered tumor-specific. It requires no external energy input, and also enables adequate therapeutic effects even in deep tumor tissues. Nevertheless, the therapeutic efficiency of CDTs is still hindered by high tumor heterogeneity. For this reason, we summarize recent advances in nanocatalyst development to achieve enhanced catalytic activities and overcome obstacles in the tumor microenvironment. The combination of CDT with other treatment modalities has also been demonstrated to improve the therapeutic outcomes. Finally, we uncover the challenges and future prospects in the development of CDT for clinical application.

並列關鍵字

Chemodynamic therapy ； Fenton/Fenton-like reactions ； Nanocatalysts ； Tumor microenvironment ； Combination therapy

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奈米催化醫學：化學動力治療

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