1.Regulation of Tumor Immune Homeostasis by Programmed Cell Death and Intervention Effect of Traditional Chinese Medicine Under Theory of Regulating Qi and Resolving Toxins
Bingwei YANG ; Xue CHEN ; Chenglei WANG ; Haoyu ZHAI ; Weidong LI ; Baojin HUA
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):212-220
Tumor immune homeostasis is a dynamic equilibrium state in which the body removes abnormal mutated cells in time to prevent tumor development without damaging other normal cells under the surveillance of the immune system. It is an important concept to understand the process of tumor development. Programmed cell death (PCD) is a kind of regulable cell death including various forms such as apoptosis, autophagy, pyroptosis, necrosis, and ferroptosis. It is regarded as an important way for the body to remove abnormal or mutated cells. In recent years, modern research has found that PCD has a bi-directional regulatory effect on carcinogenesis and tumor development. In the early stage of tumor formation, PCD can control tumor development in time by playing a specific immune clearance role, while in the later tumorigenic stage, PCD can promote the growth and development of tumor cells by forming a tumor-specific microenvironment, resulting in carcinogenic effects. Therefore, PCD is regarded as an important way to maintain tumor immune homeostasis. Based on the idea of ''supporting the vital Qi and cultivating the root'' by professors Yu Guiqing and Piao Bingkui, the team proposed the theory of ''regulating Qi and resolving toxins'' and applied it to clinical tumor prevention and treatment. Based on the theory of ''regulating Qi and resolving toxins'', the research summarized the current progress of modern medical research on mechanisms related to PCD to explore the role of PCD in the regulation of tumor immune homeostasis. The article believed that the harmonious state of Qi movement was the basic condition for normal PCD to maintain tumor immune homeostasis, while the disorder of Qi movement and the evolution of tumor toxicity were the core processes of abnormal PCD and disorder of tumor immunity homeostasis, which led to the escape and development of tumor cells. Therefore, under the guidance of ''regulating Qi and removing toxins'', the idea of full-cycle prevention and treatment of tumors was proposed summarily. In the early stage of tumor formation, the method of ''regulating Qi movement and strengthening vital Qi'' was applied to reestablish tumor immune homeostasis and to promote the elimination of abnormal cells. In the late tumorigenic stage, the method of ''resolving toxins and dispelling evils'' was applied to reverse the specific microenvironment of tumors and inhibit the development of tumor cells, with a view to providing new theoretical support for the prevention and treatment of tumors through traditional Chinese medicine.
2.Regulation of Tumor Immune Homeostasis by Programmed Cell Death and Intervention Effect of Traditional Chinese Medicine Under Theory of Regulating Qi and Resolving Toxins
Bingwei YANG ; Xue CHEN ; Chenglei WANG ; Haoyu ZHAI ; Weidong LI ; Baojin HUA
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):212-220
Tumor immune homeostasis is a dynamic equilibrium state in which the body removes abnormal mutated cells in time to prevent tumor development without damaging other normal cells under the surveillance of the immune system. It is an important concept to understand the process of tumor development. Programmed cell death (PCD) is a kind of regulable cell death including various forms such as apoptosis, autophagy, pyroptosis, necrosis, and ferroptosis. It is regarded as an important way for the body to remove abnormal or mutated cells. In recent years, modern research has found that PCD has a bi-directional regulatory effect on carcinogenesis and tumor development. In the early stage of tumor formation, PCD can control tumor development in time by playing a specific immune clearance role, while in the later tumorigenic stage, PCD can promote the growth and development of tumor cells by forming a tumor-specific microenvironment, resulting in carcinogenic effects. Therefore, PCD is regarded as an important way to maintain tumor immune homeostasis. Based on the idea of ''supporting the vital Qi and cultivating the root'' by professors Yu Guiqing and Piao Bingkui, the team proposed the theory of ''regulating Qi and resolving toxins'' and applied it to clinical tumor prevention and treatment. Based on the theory of ''regulating Qi and resolving toxins'', the research summarized the current progress of modern medical research on mechanisms related to PCD to explore the role of PCD in the regulation of tumor immune homeostasis. The article believed that the harmonious state of Qi movement was the basic condition for normal PCD to maintain tumor immune homeostasis, while the disorder of Qi movement and the evolution of tumor toxicity were the core processes of abnormal PCD and disorder of tumor immunity homeostasis, which led to the escape and development of tumor cells. Therefore, under the guidance of ''regulating Qi and removing toxins'', the idea of full-cycle prevention and treatment of tumors was proposed summarily. In the early stage of tumor formation, the method of ''regulating Qi movement and strengthening vital Qi'' was applied to reestablish tumor immune homeostasis and to promote the elimination of abnormal cells. In the late tumorigenic stage, the method of ''resolving toxins and dispelling evils'' was applied to reverse the specific microenvironment of tumors and inhibit the development of tumor cells, with a view to providing new theoretical support for the prevention and treatment of tumors through traditional Chinese medicine.
3.Mechanism of Shaoyaotang in Modulating MDSCs-related Immunosuppressive Microenvironment in Prevention and Treatment of Colitis-associated Carcinogenesis
Xue CHEN ; Chenglei WANG ; Bingwei YANG ; Haoyu ZHAI ; Ying WU ; Weidong LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):10-19
ObjectiveTo explore the mechanism of Shaoyaotang in the prevention and treatment of colitis-associated carcinogenesis (CAC) based on myeloid-derived suppressor cells (MDSCs)-related immunosuppressive microenvironment. MethodsA total of 140 six-week-old SPF FVB male mice were randomly divided into seven groups: Blank group, Shaoyaotang without model group (7.12 g·kg-1), model group, sulfasalazine group (0.52 g·kg-1), Shaoyaotang low-dose group (3.56 g·kg-1), Shaoyaotang medium-dose group (7.12 g·kg-1) and Shaoyaotang high-dose group (14.24 g·kg-1), with 20 mice in each group. The blank control group and the Shaoyaotang without model group received a single intraperitoneal injection of physiological saline (10 mg·kg-1), while the other five groups were given a single intraperitoneal injection of azoxymethane (AOM) (10 mg·kg-1). After 1 week, the mice were given drinking water containing 2% dextran sulfate sodium (DSS) for 1 week, followed by normal drinking water for 2 weeks. This cycle was repeated three times over a total period of 14 weeks to establish the CAC mouse model. Each group was administered gavage once daily for 2 weeks starting on the 14th day of the experiment, followed by three times a week until the end of the experiment. The body weight of the mice was recorded weekly. Mice were sacrificed on the 28th and 98th days of the experiment. After dissection, the colon length, colon weight, spleen weight, tumor size, and tumor number were measured. Hematoxylin and eosin (HE) staining was used to assess the pathological morphology of colon tumor tissue. Flow cytometry was used to detect MDSCs, regulatory T cells (Tregs), CD4+ T cells, CD8+ T cells, and the CD4+/CD8+ T cell ratio in the spleen. Immunohistochemistry was used to detect the expression levels of programmed cell death protein-1 (PD-1), programmed cell death ligand 1 (PD-L1), phosphorylated AMP-activated protein kinase (p-AMPK), phosphorylated nuclear factor-κB (p-NF-κB), and hypoxia-inducible factor 1α (HIF-1α) in the colon tissue. ResultsOn day 14, compared with the blank group, the body weight of the model group was significantly reduced (P<0.01), reaching its lowest point on day 28 (23.39 ± 0.95 ) g. On days 28 and 98, compared with the blank group, the colon length in the model group was significantly shortened (P<0.01), the colon index significantly increased (P<0.01), the spleen index significantly increased (P<0.01), and the tumor load significantly increased (P<0.01). HE staining showed that in the model group, tumor cells, a large number of inflammatory cell infiltrates, goblet cell disappearance, and crypt loss were observed. In each dose group of Shaoyaotang, the damage to the colonic mucosa, inflammatory cell infiltration, and crypt structure destruction were alleviated. Compared with the model group, the body weight of mice in each dose group of Shaoyaotang increased. On day 98, the colon length was significantly increased (P<0.01), the colon index significantly decreased (P<0.01), the spleen index significantly decreased (P<0.01), and the tumor burden significantly decreased (P<0.01) in each Shaoyaotang dose group. On days 28 and 98, MDSCs and Tregs in the spleen of the medium- and high-dose Shaoyaotang groups were significantly reduced (P<0.01), while CD4+ T cells and the CD4+/CD8+ T cell ratio were significantly increased (P<0.01). The proportion of CD8+ T cells in the spleen and the expression levels of PD-1 and PD-L1 in the colon tissues of mice in each Shaoyaotang dose group were significantly increased to varying degrees (P<0.05, P<0.01). On days 28 and 98, the expression of p-AMPK-positive cells in the colon tissue of the medium- and high-dose Shaoyaotang groups was significantly increased (P<0.01), while the expression of p-NF-κB and HIF-1α was significantly reduced (P<0.01). ConclusionShaoyaotang can regulate MDSC recruitment and modulate the immune function of T lymphocyte subsets to inhibit the occurrence and development of AOM/DSS-induced CAC in mice. The mechanism may be related to the activation of the AMPK/NF-κB/HIF-1α pathway.
4.Clinical Study on Treatment of Melasma Using Angelica and Safflower Spot Removal Essence Based on State-target Medicine
Bailin CHEN ; Haoyu YANG ; Rui CAI ; Yanping BAI ; Yuanyuan CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):111-119
ObjectiveTo investigate the clinical efficacy and safety of state-target formula Angelica and Safflower spot removal essence in the treatment of melasma. MethodsA randomized,double-blind,placebo-controlled parallel-group trial was conducted,selecting patients with Qi stagnation and blood stasis type of melasma who visited the dermatology outpatient department of Beijing Hospital of Integrated Traditional Chinese and Western Medicine from September 2022 to February 2023. In accordance with the double-blind principle,a random number table was generated to randomly divide the patients into an experimental group (50 cases) and a control group (50 cases). The experimental group applied the Angelica and Safflower spot removal essence topically,while the control group applied a placebo topically,with continuous treatment for 8 weeks and a follow-up of 1 month. Melasma Area and Severity Index (MASI),Physician Global Assessment (PGA),patient self-assessment scoring,VISIA detection and scoring were performed before medication and on the first day after stopping medication,and all adverse events were recorded. ResultsIn a study involving 100 patients,87 cases were included in the analysis. The experimental group consisted of 45 cases,with 5 dropouts,and the control group had 42 cases,with 8 dropouts. The baseline data of the patients in both groups were consistent,with no statistically significant differences. After treatment,the total effective rate of the experimental group was 75.56% (34/45),significantly higher than the control group's 2.38% (1/42),and the difference was statistically significant (χ2=48.38,P<0.01). Compared with before treatment,after treatment,the MASI score,VISIA image spot,brown spot,and red area score of the experimental group patients were significantly reduced (P<0.05,P<0.01),while there was no statistically significant difference in the control group patients. Compared with the control group after treatment,the experimental group showed more significant improvement (P<0.05,P<0.01). VISIA image analysis showed that after 8 weeks of treatment,the experimental group showed significant improvement in surface spots,deep spots,and red areas,while the control group remained unchanged or showed an increasing trend. 42.22% (19/45) of the experimental group had a PGA score of 3 or below,while 88.89% (40/45) had a PGA score of 4 or below. 80.95% (34/42) of the control group had a PGA score of 5 or above,and the difference between the two groups was statistically significant (χ2=38.26,P<0.01). There was no statistically significant difference in the recurrence rate and adverse reaction rate within one month between the experimental group and the control group. ConclusionThe state-target formula Angelica and Safflower spot removal essence is clinically effective and safe in the treatment of melasma.
5.Exploring the Composition Rules of Rrescriptions Containing the Pair of Aurantii Fructus Immaturus-Magnoliae Officinalis Cortex and Its Mechanism of Action in the Treatment of Food Retention Disorder Based on Data Mining,Network Pharmacology and Molecular Docking
Wenbo LI ; Yangang WANG ; Jiayi MA ; Haoyu CHEN ; Yuhua WANG ; Haiyan BAI
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(4):1165-1178
Objective Excavate the prescriptions containing the drug pair of Aurantii Fructus Immaturus-Magnoliae Officinalis Cortex(AFI-MOC),and statistically analyze the rules of prescription medication,and explore its potential mechanism of action in the treatment of food retention disorder.Methods The prescriptions containing the pair of AFI-MOC in the Great Dictionary of Traditional Chinese Medicine Prescriptions were retrieved and typed into Excel to establish a database.The source,dosage form,frequency of compatibility of traditional Chinese medicine,nature,taste and meridian attribution and indications were analyzed.Using R language(4.3.3)software with OriginPro to analysis co-occurrence frequency,association rule,correlation clustering analysis,and visualization.Then,the network construction,Protein-Protein Interaction Network(PPI)analysis,Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genome(KEGG)pathway enrichment analysis of the"AFI-MOC-active ingredient-food retention disorder target"network were performed for the AFI-MOC drug pair and its indications food retention disorder.The binding between the core active ingredients and key target proteins was evaluated by molecular docking.Results A total of 349 prescriptions containing the pair of AFI-MOC were included,involving 267 Chinese herbs.Among them,the high-frequency compatibility drugs included Citri Reticulatae Pericarpium,Glycyrrhizae Radix et Rhizoma,Atractylodis Macrocephalae Rhizoma,Rhei Radix et Rhizoma and Aucklandiae Radix.They are mainly warm in nature,spicy,bitter and sweet in taste,spleen,liver and stomach in meridian.There were 141 kinds of indications,most of which were diseases of the spleen and stomach system such as food retention disorder,dysentery and fullness.Correlation cluster analysis shows that the AFI-MOC drug pair is frequently combined with drugs that have the efficacy of promoting qi circulation,strengthening the spleen,clearing heat,and eliminating dampness.Found through the analysis of network pharmacology AFI-MOC drug pair on the core of the active ingredient of Luteolin,BU3,Naringenin,Honokiol and Nobiletin.Key targets for food retention disorder are BDNF,AKT1,ESR1,TNF and IL-6.Molecular docking results show Luteolin,combined with AKT1 is most closely.Conclusion AFI-MOC drug pair often compatible with Citri Reticulatae Pericarpium,Atractylodis Macrocephalae Rhizoma,Aucklandiae Radix.The advantages of the prescription containing AFI-MOC drug pair is food retention disorder.Its key active components can exert therapeutic effects through multiple targets such as AKT1 and TNF.This study reveals the AFI-MOC drug pair on compatibility laws,preliminary interpretation of the mechanism for the treatment of food retention disorder.It can provide references and a basis for studying the compatibility mechanism of AFI-MOC and guiding rational clinical medication.
6.Development and validation of the Online Fraud Susceptibility Scale
Haoyu WANG ; Dan WANG ; Chen YANG
Chinese Mental Health Journal 2025;39(11):981-987
Objective:To develop and validate the Online Fraud Susceptibility Scale(OFSS).Methods:The construct of online fraud susceptibility was defined through qualitative interviews(n=14)and expert evaluations(n=6).Based on prior literature,an initial item pool was generated.A sample of 805 adults completed the preliminary scale for item analysis and exploratory factor analysis(EFA).Another sample of 491 adults completed the formal scale for confirmatory factor analysis(CFA),criterion validity,and internal consistency analysis.Of these,233 par-ticipants were retested after four months.The Vulnerability to Fraud Questionnaire(VFQ)and the Susceptibility to Persuasion-Ⅱ Scale(StP-Ⅱ)were used as criterion measures.Results:The 25-item OFSS consisted of 5 factors,na-rely monetary motivation,heuristic processing,financial risk-seeking,anti-fraud knowledge,and susceptibility to so-cial influence,explaining 51.94%of the total variance.The factor loadings ranged from 0.52 to 0.80.The 5-factor model showed an acceptable structural fit(x2/df=2.39,CFI=0.86,TLI=0.84,CFI=0.86,RMSEA=0.05).The OFSS scores were positively correlated with the scores of VFQ and StP-Ⅱ(r=0.51,0.47,Ps<0.001).The inter-nal consistency reliabilities of the total score and 5 factors ranged from 0.64 to 0.80,and the retest reliabilities(ICC)of the total score and 5 factors ranged from 0.53 to 0.78.Conclusion:The Online Fraud Susceptibility Scale demonstrates satisfactory psychometric properties providing a practical tool to assess the vulnerability to online fraud.
7.Evaluation of the effect of vitamin D on improving autism symptoms based on the microbiota-gut-brain axis
Haoyu HUANG ; Xiaoliang DU ; Jing WANG ; Jinting WU ; Zhuo ZOU ; Yingjuan CHEN ; Yun LIU
Chinese Journal of Nervous and Mental Diseases 2025;51(3):149-155
Objective To analyze the symptomatic improvement effects of vitamin D in children with autism spectrum disorder(ASD)based on the microbiota-gut-brain axis.Methods Seventy-two children with ASD were randomly divided into an observation group and a control group,with 36 cases in each group.Three cases dropped out in the control group.The observation group received 1200 IU/day of vitamin D supplementation in addition to conventional rehabilitation training,while the control group received only conventional rehabilitation training.The intervention lasted for 12 weeks.Assessments were conducted before and after the intervention using the childhood autism rating scale(CARS),autism behavior checklist(ABC),and repetitive behavior scale-revised(RBS-R).Resting-state functional connectivity of the brain was measured using near-infrared functional imaging,and serum levels of 25(OH)D3,inflammatory cytokines,and gut microbiota were analyzed.The differences in these indicators before and after the intervention were compared between the two groups to evaluate clinical efficacy.Results The between-group differences in pre-and post-intervention changes showed that the observation group had significantly greater improvements than the control group in the following measures:CARS scores(-5.92±1.40 vs.-2.55±1.43),RBS-R scores(-5.99±1.01 vs.-3.10±1.47),resting-state brain functional connectivity(0.19±0.15 vs.0.10±0.18),serum 25(OH)D3 levels[(34.89±8.18)ng/mL vs.(0.68±6.73)ng/mL],serum interleukin-6(IL-6)levels[(-6.60±6.07)pg/mL vs.(-0.74±9.45)pg/mL],IL-1β levels[(-2.56±1.33)pg/mL vs.(-0.04±2.13)pg/mL],and tumor necrosis factor-α(TNF-α)levels[(-4.09±3.85)pg/mL vs.(0.21±4.05)pg/mL](P<0.05).Post-intervention,significant differences in gut microbial β-diversity were observed between the two groups(R2=0.030,P=0.040,Adonis).LEfSe analysis revealed that the observation group exhibited enrichment in Clostridia(LDA=4.747,P=0.003),Clostridiales(LDA=4.747,P=0.003),Clostridiaceae(LDA=3.476,P=0.001),Lachnospiraceae(LDA=4.709,P=0.004),Odoribacteraceae(LDA=3.458,P=0.027),Odoribacter(LDA=3.458,P=0.027),Burkholderiales(LDA=3.339,P=0.038),Firmicutes(LDA=4.764,P=0.003),and Betaproteobacteria(LDA=3.338,P=0.037).Conclusion Vitamin D supplementation can modulate gut microbial diversity in children with ASD,significantly influence the abundance of specific gut microbiota,reduce systemic inflammatory cytokines,enhance brain functional connectivity,and alleviate clinical symptoms of ASD.
8.Evaluation of the Efficacy of Gouteng Xuanshen Prescription in the Treatment of Hypertension:A Retrospective Cohort Study Based on Real-World Data
Jiaming HUAN ; Zhen HUA ; Haoyu CHEN ; Xiaojie WANG ; Linghui KONG ; Yunlun LI
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(3):832-841
Objective To provide a reference for the clinical individualized medication of hypertension,the antihypertensive efficacy of Gouteng Xuanshen prescription in the treatment of hypertension was verified,and its improvement on the discomfort symptoms of patients was explored.Methods This study adopted a retrospective cohort study design.The data were derived from the electronic medical records of 6770 hypertensive patients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1,2013 to January 1,2023.The exposure factor was the treatment of Uncaria rhynchophylla,Scrophularia ningpoensis,and Radish Seed.After the propensity score was used to deal with the confounding factors,the changes in blood pressure of the patients after treatment were observed.At the same time,in order to analyze the improvement of patients'symptoms,the Apriori algorithm to mine the core symptoms of patients was explored,and the patient symptom network was constructed.The BGLL algorithm was used to divide the symptoms into communities to form a symptom map.Finally,survival analysis and Cox regression were used to find the sensitive symptom community of Gouteng Xuanshen prescription,and the related factors were analyzed.Results 468 people were included in the exposure group and the control group.After treatment,more patients in the exposure group reached the target blood pressure(P<0.01),and the effect was better in lowering systolic blood pressure(P<0.05),and no obvious abnormalities in safety indicators were found.In terms of symptom improvement,the 134 symptoms recorded in the medical records were divided into 6 groups.As the medication time increased,the patient's head discomfort was easier to relieve.The effect was best at 8 weeks of treatment,and it was more sensitive to patients with extremely high cardiovascular risk or grade 3 hypertension.Conclusion This study verified the clinical efficacy of the Gouteng Xuanshen prescription in the treatment of hypertension through electronic medical record data,which preliminarily revealed the potential role and law of the Gouteng Xuanshen prescription in the treatment of hypertension.
9.Silencing PTPN2 with nanoparticle-delivered small interfering RNA remodels tumor microenvironment to sensitize immunotherapy in hepatocellular carcinoma.
Fu WANG ; Haoyu YOU ; Huahua LIU ; Zhuoran QI ; Xuan SHI ; Zhiping JIN ; Qingyang ZHONG ; Taotao LIU ; Xizhong SHEN ; Sergii RUDIUK ; Jimin ZHU ; Tao SUN ; Chen JIANG
Acta Pharmaceutica Sinica B 2025;15(6):2915-2929
Protein tyrosine phosphatase nonreceptor type 2 (PTPN2) is a promising target for sensitizing solid tumors to immune checkpoint blockades. However, the highly polar active sites of PTPN2 hinder drug discovery efforts. Leveraging small interfering RNA (siRNA) technology, we developed a novel glutathione-responsive nano-platform HPssPT (HA/PEIss@siPtpn2) to silence PTPN2 and enhance immunotherapy efficacy in hepatocellular carcinoma (HCC). HPssPT showed potent transfection and favorable safety profiles. PTPN2 deficiency induced by HPssPT amplified the interferon γ signaling in HCC cells by increasing the phosphorylation of Janus-activated kinase 1 and signal transducer and activator of transcription 1, resulting in enhanced antigen presentation and T cell activation. The nano-platform was also able to promote the M1-like polarization of macrophages in vitro. The unique tropism of HPssPT towards tumor-associated macrophages, facilitated by hyaluronic acid coating and CD44 receptor targeting, allowed for simultaneous reprogramming of both tumor cells and tumor-associated macrophages, thereby synergistically reshaping tumor microenvironment to an immunostimulatory state. In HCC, colorectal cancer, and melanoma animal models, HPssPT monotherapy provoked robust antitumor immunity, thereby sensitizing tumors to PD-1 blockade, which provided new inspiration for siRNA-based drug discovery and tumor immunotherapy.
10.PROTAC-loaded nanocapsules degrading BRD4 for radio-chemotherapy sensitization in glioblastoma.
Yun GUO ; Mingzhu FANG ; Shilin ZHANG ; Zheng ZHOU ; Zonghua TIAN ; Haoyu YOU ; Yun CHEN ; Jingyi ZHOU ; Xiaobao YANG ; Yunke BI ; Chen JIANG ; Tao SUN
Acta Pharmaceutica Sinica B 2025;15(10):5050-5070
Glioblastoma (GBM) is a highly aggressive primary brain tumor characterized by poor prognosis. Conventional chemo-radiotherapy demonstrates limited therapeutic efficacy and is often accompanied by significant side effects, largely due to factors such as drug resistance, radiation resistance, the presence of the blood-brain barrier (BBB), and the activation of DNA damage repair mechanisms. There is a pressing need to enhance treatment efficacy, with BRD4 identified as a promising target for increasing GBM sensitivity to therapy. Lacking small molecule inhibitors, BRD4 can be degraded using PROteolysis Targeting Chimera (PROTAC), thereby inhibiting DNA damage repair. To deliver PROTAC, SIAIS171142 (SIS) effectively, we designed a responsive nanocapsule, MPL(SS)P@SIS, featuring GBM-targeting and GSH-responsive drug release. Modified with 1-methyl-l-tryptophan (MLT), nanocapsules facilitate targeted delivery of SIS, downregulating BRD4 and sensitizing GBM cells to radiotherapy and chemotherapy. After intravenous administration, MPL(SS)P@SIS selectively accumulates in tumor tissue, enhancing the effects of radiotherapy and temozolomide (TMZ) by increasing DNA damage and oxidative stress. GSH activates the nanocapsules, triggering BRD4 degradation and hindering DNA repair. In mouse models, the nanosensitizer, combined with TMZ and X-ray irradiation, efficiently inhibited the growth of GBM. These findings demonstrate a novel PROTAC-based sensitization strategy targeting BRD4, offering a promising approach for effective GBM therapy.

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