Enhanced Fe(<sc>ii</sc>)-artemisinin-mediated chemodynamic therapy with efficient Fe(<sc>iii</sc>)/Fe(<sc>ii</sc>) conversion circulation for cancer treatment

Existing strategies to investigate the antitumor effects of artemisinin and its derivatives (ART) are inadequate. Both free Fe(II) and heme in mitochondria have been proposed to be ART activators. However, the two impact factors have been considered separately or have not been thoroughly investigated. Here, the designed ART-based novel nanosystem with transferrin-modified hollow mesoporous silica nanoparticles as drug-delivery carriers is loaded with a functional artemisinin derivative (Cou-DHA), glucose oxidase, and perfluoropentane inside the cavity, which can enhance synergistic Fe(II)-ART-mediated chemodynamic therapy (CDT). Under the action of H2O2 generated by starvation therapy, the Fenton reaction occurs with Fe(III) in transferrin converted into free Fe(II). Remarkably, this report is the first to provide Fe(II) to ART actively and efficiently by combining starvation therapy and Fenton reaction-based CDT. Importantly, mitochondria-targeted Cou-DHA delivers ART into the mitochondria to sensitize the anticancer effects of ART with the supplied Fe(II) to realize Fe(II)-ART-mediated CDT. The ART-based novel nanosystem developed in our work thus has great potential for exploitation in advanced cancer therapies.