Leveraging tumor microenvironment metabolism for smart drug delivery systems
Mahsa Asadi,1Masouma Nazari,2Ahmad Reza Bahrami,3Tara Akhtarkhavari,4Maryam M Matin,5,*
1. Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran. 2. Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran. 3. Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran. 4. Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran. 5. Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran.
Introduction: The tumor microenvironment (TME) is a metabolically reprogrammed environment where cancer, stromal, and immune cells interact to promote malignancy and therapeutic resistance. Intracellular changes—such as enhanced glycolysis, glutaminolysis, lipid synthesis, and redox imbalance—coexist with extracellular alterations, including acidosis, hypoxia, lactate accumulation, reactive oxygen species (ROS), and elevated enzyme activity, offering opportunities for targeted drug delivery. This review classifies TME-associated metabolic changes based on their subcellular location (intracellular or extracellular). Intracellular alterations are further categorized by cell type and metabolic pathway, emphasizing their potential as targets for smart drug delivery systems.
Methods: A comprehensive literature review (2020–2024) was conducted, focusing on metabolic pathways altered in cancer cells, cancer-associated fibroblasts (CAFs), tumor-associated macrophages (TAMs), T cells, endothelial cells, and other TME components. Data were organized by metabolic pathway, cellular location, functional impact, and corresponding drug delivery challenges and opportunities.
Results: Intracellularly, cancer cells show upregulated glycolysis (Warburg effect), glutaminolysis, and fatty acid synthesis with downregulated oxidative phosphorylation; CAFs exhibit reverse Warburg metabolism; TAMs and Myeloid-Derived Suppressor Cells (MDSCs) display enhanced fatty acid oxidation and arginine/tryptophan catabolism; exhausted T cells and endothelial cells show impaired glucose and oxygen metabolism. Extracellularly, the TME is characterized by low pH, high lactate levels, hypoxia, elevated reactive oxygen species/reactive nitrogen species, matrix-remodeling enzymes, and increased interstitial fluid pressure.
Conclusion: We categorize these metabolic signatures to provide a clear framework for designing smart drug delivery systems. Integrating these insights with advanced biomaterials and nanotechnologies holds promise for next-generation precision cancer therapies.
Keywords: Cancer, Tumor microenvironment, Metabolic reprogramming, Smart drug delivery, Nanoparticles
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