Figure 5.

Strategies employed by NGs to overcome tumor resistance to PDT. (A) At the host level, NG-supported devices detect various biomarkers for early identification of metastasis and enhance immune activity to improve survival. (B) At the tumor level, ①A TENG-based sensor detect dopamine levels with anti-angiogenic properties. ② PENG/TENG systems facilitate thermal therapy, increasing O2 supply, relieving hypoxia, and enhancing ROS production. RR-TENG or TENG-Cat directly stimulate ROS production. ③ PENG/TENG-supported drug delivery systems(DDSs) enhance PS absorption, excitation, and ROS production for deep-seated or irregularly shaped tumors. (C) At the subcellular level, ① NG devices influence cell death signals, with TENG enhancing ROS production and inducing necrosis or enhancing apoptosis through Bcl-2 gene silencing or autophagy suppression. ② NG devices suppress pro-survival signals by increasing ROS production and silencing pro-survival genes or activating the AMPK signal to regulate mTOR-HIF1 signaling. ③Silencing the Mutt homolog 1(MTH1) gene reduces protein repair damaged by ROS. ④ TENG devices silence P-gp and ABCG2 to reduce photosensitizer exocytosis. TENG-based glucose sensors detect ATP production. ⑤ A designed D-TENG enhances cancer cell endocytosis and PS absorption.