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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Oncol.</journal-id>
<journal-title>Frontiers in Oncology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Oncol.</abbrev-journal-title>
<issn pub-type="epub">2234-943X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fonc.2023.1126094</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Oncology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Inhibition of melanoma using a nanoceria-based prolonged oxygen-generating phototherapy hydrogel</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>Lidong</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1922282"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Liu</surname>
<given-names>Xiaoguang</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mao</surname>
<given-names>Yinghua</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rong</surname>
<given-names>Shu</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chen</surname>
<given-names>Yonghong</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Qi</surname>
<given-names>Yong</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cai</surname>
<given-names>Zhipeng</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Li</surname>
<given-names>Hong</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2142190"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University)</institution>, <addr-line>Chongqing</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Gynecology, Women&#x2019;s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital)</institution>, <addr-line>Nanjing</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Centre for Diseases Prevention and Control of Eastern Theater</institution>, <addr-line>Nanjing</addr-line>, <country>China</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Huadong Research Institute for Medicine and Biotechniques</institution>, <addr-line>Nanjing</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Luis Alexandre Muehlmann, University of Brasilia, Brazil</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Suresh Thangudu, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Linawati Sutrisno, Chongqing University, China; Yishen Zhu, Nanjing Tech University, China</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Hong Li, <email xlink:href="mailto:lihong0708@sina.com">lihong0708@sina.com</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p>
</fn>
<fn fn-type="other" id="fn002">
<p>This article was submitted to Skin Cancer, a section of the journal Frontiers in Oncology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>16</day>
<month>03</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>13</volume>
<elocation-id>1126094</elocation-id>
<history>
<date date-type="received">
<day>17</day>
<month>12</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>23</day>
<month>01</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Zhang, Liu, Mao, Rong, Chen, Qi, Cai and Li</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Zhang, Liu, Mao, Rong, Chen, Qi, Cai and Li</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Tumor hypoxic environment is an inevitable obstacle for photodynamic therapy (PDT) of melanoma. Herein, a multifunctional oxygen-generating hydrogel loaded with hyaluronic acid-chlorin e6 modified nanoceria and calcium peroxide (Gel-HCeC-CaO<sub>2</sub>) was developed for the phototherapy of melanoma. The thermo-sensitive hydrogel could act as a sustained drug delivery system to accumulate photosensitizers (chlorin e6, Ce6) around the tumor, followed by cellular uptake mediated by nanocarrier and hyaluronic acid (HA) targeting. The moderate sustained oxygen generation in the hydrogel was produced by the reaction of calcium peroxide (CaO<sub>2</sub>) with infiltrated H<sub>2</sub>O in the presence of catalase mimetic nanoceria. The developed Gel-HCeC-CaO<sub>2</sub> could efficiently alleviate the hypoxia microenvironment of tumors as indicated by the expression of hypoxia-inducible factor -1&#x3b1; (HIF-1&#x3b1;), meeting the &#x201c;once injection, repeat irradiation&#x201d; strategy and enhanced PDT efficacy. The prolonged oxygen-generating phototherapy hydrogel system provided a new strategy for tumor hypoxia alleviation and PDT.</p>
</abstract>
<kwd-group>
<kwd>photodynamic therapy</kwd>
<kwd>hydrogel</kwd>
<kwd>melanoma</kwd>
<kwd>nanaoceria</kwd>
<kwd>hypoxia alleviation</kwd>
</kwd-group>
<counts>
<fig-count count="5"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="55"/>
<page-count count="9"/>
<word-count count="4446"/>
</counts>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>The global morbidity and mortality of melanoma are increased dramatically, which is still one of the severe threats to public health (<xref ref-type="bibr" rid="B1">1</xref>&#x2013;<xref ref-type="bibr" rid="B3">3</xref>). However, traditional tumor treatment often confronts obstacles due to visible toxic side effects and drug resistance (<xref ref-type="bibr" rid="B4">4</xref>). Recently, synergetic photodynamic therapy (PDT) has been introduced to overcome melanoma and has shown great potential in the field of tumor therapy (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B6">6</xref>). As a noninvasive technology, PDT addresses spectacular advantages such as high localized tissue damage and minimal side effects (<xref ref-type="bibr" rid="B7">7</xref>). In the PDT process, photosensitizers such as chlorin e6 (Ce6) accumulated in tumor tissues are usually activated and energized by a specified light, resulting in reactive oxygen species (ROS) generation and singlet oxygen (<sup>1</sup>O<sub>2</sub>) in the presence of biological substrates and oxygen (<xref ref-type="bibr" rid="B8">8</xref>). Therefore, oxygen and photosensitizer contents in tumor tissues are restrictive factors for PDT reaction and cytotoxicity (<xref ref-type="bibr" rid="B9">9</xref>). However, the therapeutic efficacy of PDT is often unsatisfactory because of the hypoxic microenvironment in most malignant tumors and rapid drug metabolism-induced short-term effects (<xref ref-type="bibr" rid="B10">10</xref>&#x2013;<xref ref-type="bibr" rid="B12">12</xref>). It is of great significance to alleviate hypoxia and prolong photosensitizer supply in the tumor environment for enhancing PDT efficacy.</p>
<p>Several efforts have been conducted to overcome tumor hypoxia, such as water splitting (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B14">14</xref>), respiratory inhibitor (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B16">16</xref>), O<sub>2</sub>-evolving agents (<xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B18">18</xref>), catalase (<xref ref-type="bibr" rid="B19">19</xref>, <xref ref-type="bibr" rid="B20">20</xref>), and nanoscale metal-organic framework (<xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B22">22</xref>). Among them, catalase could effectively improve the efficacy of oxygen supply and PDT treatment because of the catalytic decomposition of elevated H<sub>2</sub>O<sub>2</sub> in the tumor environment (<xref ref-type="bibr" rid="B23">23</xref>, <xref ref-type="bibr" rid="B24">24</xref>). However, the poor stability, cost, and limited catalyst capacity restrict the application of natural catalase. These limitations have emerged the nanoenzymes, which are defined as nanomaterials with enzyme-like characteristics (<xref ref-type="bibr" rid="B25">25</xref>, <xref ref-type="bibr" rid="B26">26</xref>). Numbers of nanomaterials based on iron oxides (<xref ref-type="bibr" rid="B27">27</xref>), copper oxides (<xref ref-type="bibr" rid="B28">28</xref>, <xref ref-type="bibr" rid="B29">29</xref>), vanadium oxides (<xref ref-type="bibr" rid="B30">30</xref>, <xref ref-type="bibr" rid="B31">31</xref>), and noble metals (Au, Ag, Pt, Pd) (<xref ref-type="bibr" rid="B32">32</xref>&#x2013;<xref ref-type="bibr" rid="B36">36</xref>) have been reported to mimic catalase activity.</p>
<p>Cerium nanoparticles (CeNPs) are a remarkably versatile rare earth nanomaterial with excellent catalytic activities (<xref ref-type="bibr" rid="B37">37</xref>, <xref ref-type="bibr" rid="B38">38</xref>). It has been reported to mimic multiple types of enzymes due to the electron shuttle between their mixed oxidation states (Ce<sup>3+</sup>/Ce<sup>4+</sup>) and has emerged as a fascinating material in biological fields (<xref ref-type="bibr" rid="B39">39</xref>). Recently, we demonstrated that chemically cytotoxic and oxygen-carrying CeNPs could act as a nanocarrier to deliver photosensitizers into tumor cells, resulting in enhanced PDT efficacy (<xref ref-type="bibr" rid="B40">40</xref>, <xref ref-type="bibr" rid="B41">41</xref>). In this study, to obtain sufficient oxygen generation for PDT, the CeNPs nanocarrier was introduced into the system and used as an ideal renewable catalase-like enzyme to catalyze the reaction of CaO<sub>2</sub> and H<sub>2</sub>O. Herein, we designed a prolonged oxygen-generating phototherapy hydrogel system (Gel-HCeC-CaO<sub>2</sub>) to improve the therapeutic efficacy of PDT in treating melanoma.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<label>2</label>
<title>Materials and methods</title>
<sec id="s2_1">
<label>2.1</label>
<title>Chemicals and reagents</title>
<p>Poloxamer P407 (F127) and Poloxamer P188 (F68) were purchased from BASF,Germany. H<sub>2</sub>O<sub>2</sub> (technical grade, 30%) was offered by Aladdin,China. CaO<sub>2</sub>, Cerium (III) nitrate hexahydrate, Docusate sodium(AOT), and Alendronate sodium were offered by Sigma Aldrich,USA. Chlorin e6 (Ce6) was offered by Frontier Scientific, Inc,USA. HA with a molecular weight (MW) of 17kDa was purchased from Lifecore Co. Dulbecco&#x2019;s modified Eagle&#x2019;s medium (DMEM), Fetal bovine serum (FBS) and Trypsin-EDTA (0.25%) were purchased from Gibco,USA. The Cell counting kit-8 (CCK-8 kit) were purchased from Dojindo,Japan. Trizol reagent was offered by Invitrogen,USA. PrimeScript RT Master Mix was purchased from Takara,Japan. SYBR Green PCR Master Mix was purchased from Applied Biosystems,USA. All chemicals and reagents were of analytical grade.</p>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Synthesis of materials</title>
<p>The naked cerium oxide nanoparticles (MCeNPs), cerium oxide nanoparticles-alendronate (CeNPs-AL), hyaluronic acid-chlorin e6 modified nanoceria (HCeC), and Gel-HCeC-CaO<sub>2</sub> were prepared as described in the literature (<xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B42">42</xref>).</p>
<p>MCeNPs: 0.4548&#xa0;g AOT and 1.5&#xa0;ml Ce(NO<sub>3</sub>)<sub>3</sub>&#xb7;6H<sub>2</sub>O aqueous solution(0.1 M) were added to 30&#xa0;ml methylbenzene under potent stirring for 45&#xa0;min (4500 rpm/min). Then H<sub>2</sub>O<sub>2</sub> was added using a pipette tip slowly under potent stirring for 1&#xa0;h (4500 rpm/min).</p>
<p>CeNPs-AL: 20 mg AL,200 mg Na<sub>2</sub>CO<sub>3,</sub> and 10&#xa0;ml MCeNPs were added to 5&#xa0;ml ddH<sub>2</sub>O under potent stirring for 24&#xa0;h, then centrifugal (5&#xa0;min,3000 rpm). After that, we used a dialysis bag (Thermo, 10kDa) to dialyze the acquired CNPs-AL for 24&#xa0;h.</p>
<p>HCeC: 0.5 mL Ce(NO<sub>3</sub>)<sub>3</sub>&#xb7;6H<sub>2</sub>O aqueous solution(0.1 M) were added to 10 mL HA aqueous solution(5 mg&#xb7;ml<sup>-1</sup>) at 37 &#xb0;C under potent stirring. After 15&#xa0;min, 0.8&#xa0;ml sodium hydroxide (NaOH) (1M) was added to the mixture and stirred for 30&#xa0;min. Then, 400 &#x3bc;l Ce6 (10 mM) was quickly added and stirred for 5.5&#xa0;h. After that, the dialysis bag (Thermo, 10 kDa) was used to dialyze the acquired HCeC for 24&#xa0;h in dark and rinsed with water repeatedly in a sleeve tube (Millipore, 30 kD). The acquired HCeC were dispersed in ddH<sub>2</sub>O (HCe not contained Ce6).</p>
<p>Gel-HCeC-CaO<sub>2</sub>: 0.26&#xa0;g Poloxamer407 (F127),7.5 mg CaO<sub>2</sub> were mixed in a 1 mL bottle, then 400 &#x3bc;L PoloxamerP188 (F68) and 313 &#x3bc;L HCeC were added to it. At last, ddH<sub>2</sub>O was added to 1 mL and acquired Gel-HCeC-CaO<sub>2</sub> system (Gel not contained CaO<sub>2</sub> and HCeC, Gel-CaO<sub>2</sub> only included CaO<sub>2</sub>).</p>
</sec>
<sec id="s2_3">
<label>2.3</label>
<title>Characterization of HCe and HCeC</title>
<p>The zeta potential of the HCe and HCeC were determined using dynamic light scattering(Invitrogen, America). The hydration of nanoparticles was determined by dynamic light scattering (DLS) analysis. The HCe and HCeC were characterized by HR-TEM (FEI, America) at an accelerating voltage of 200 kV. The fluorescence spectra of Ce6, HCe, and HCe6 were determined by Fluoromax-4 spectrofluorometer (Horiba Jobin Yvon Inc, France) at 405nm excitation light. The absorption spectra of Ce6, HCe, and HCeC solution were determined by a UV spectrophotometer (KAIAO, China). Moreover, the HCe and HCeC were cultured with ddH<sub>2</sub>O&#x2ce;PBS &#x2ce;DMEM&#x2ce;DMEM+ 10% FBS for 24&#xa0;h to observe the stability. The photosensitivity of HCeC was detected by singlet oxygen sensor green reagent (SOSG). And we mixed the HCeC with 50 mM H<sub>2</sub>O<sub>2</sub> to show the CAT-like activity of the HCeC.</p>
</sec>
<sec id="s2_4">
<label>2.4</label>
<title>Sol-Gel transition behavior of the Gel-HCeC-CaO<sub>2</sub> system</title>
<p>1 mL Gel and Gel-HCeC-CaO<sub>2</sub> solution were added into a 10 mL bottle, then put the bottle into a 37 &#xb0;C water bath at a different time until the solution transformed to gel, recording the time (<xref ref-type="bibr" rid="B43">43</xref>). The test tube inverting method was used to determine the sol-gel transition behavior of the hydrogel (<xref ref-type="bibr" rid="B44">44</xref>), 1 mL Gel and Gel-HCeC-CaO<sub>2</sub> solution was placed in a 10 mL bottle at -20 &#xb0;C, 4 &#xb0;C, 25 &#xb0;C, and 37 &#xb0;C to observe the solution transformed to gel. 1 mL Gel-HCeC-CaO<sub>2</sub> solution was placed in a 10 mL bottle and incubated at 37 &#xb0;C for 5&#xa0;min to gel. 1 mL PBS (pH = 7.4, 37 &#xb0;C) and CaCl<sub>2</sub> solution were gently added into the bottle as a release medium. The bottles were shaken at the speed of 50 rpm in a thermostatic shaker (HENGZI, China) at 37&#xb0;C while the weight of the gel was measured every 20&#xa0;min.</p>
</sec>
<sec id="s2_5">
<label>2.5</label>
<title>Oxygen generation of the Gel-HCeC-CaO<sub>2</sub> system</title>
<p>N<sub>2</sub> was injected into 30 mL PBS for 30&#xa0;min to produce the deoxygenated PBS. The deoxygenated PBS was divided into two groups, and the PH was adjusted by concentrated hydrochloric acid to 5.4 and 7.2, respectively. 5 mL Gel-HCeC-CaO<sub>2</sub> solution were put into a 50 mL centrifuge tube and incubated at 37 &#xb0;C for 5&#xa0;min to gel. Then, 30 mL deoxygenated PBS (PH=7.2/5.4, 37 &#xb0;C) was added into Gel-HCeC-CaO<sub>2</sub> solution. Afterward, we added 10 mL cooking oil isolate deoxygenated PBS and air. We used the Dissolved Oxygen Meters (Mettler, Switzerland) to detect oxygen generation.</p>
</sec>
<sec id="s2_6">
<label>2.6</label>
<title>Cell experiment and design</title>
<p>We obtained the murine melanoma cells (B16F10) lines from the Chinese Academy of Sciences cell bank. Cells were cultured in RPMI 1640 culture medium containing 10% FBS and 1% penicillin-streptomycin in a controlled environment (37 &#xb0;C, 95% air, 5% CO<sub>2</sub>).</p>
<p>Cell migration assay: B16F10 cells were seeded into 6-well plates and allowed to grow 80%-90% confluence. We used a sterile 20 &#x3bc;L pipette tip to scrape the confluent monolayer to form a cell-free zone. Then, B16F10 cells were incubated with HCeC (1 &#x3bc;g &#xb7;mL<sup>&#x2212;1</sup>) or Gel-HCeC-CaO<sub>2</sub> (1 &#x3bc;g &#xb7;mL<sup>&#x2212;1</sup>) for 24&#xa0;h and irradiated by the 660 nm laser(200 mW/cm<sup>2</sup>) irradiation for 5 min (<xref ref-type="bibr" rid="B45">45</xref>). Cells were photographed at 0, 24, and 48&#xa0;h with a light microscope (Olympus, Japan).</p>
<p>Cytotoxicity assays: B16F10 cells were seeded at an initial density of 1 &#xd7; 10<sup>4</sup> in 200 &#xb5;l RPMI 1640 medium. After 24&#xa0;h, cells were incubated with HCeC (0,0.125,1.25,12.5,25 &#x3bc;g&#xb7;mL<sup>-1</sup>, dark, laser) or Gel-HCeC-CaO<sub>2</sub> (0,0.005,0.05,0.5,1 &#x3bc;g&#xb7;mL<sup>&#x2212;1</sup>, dark, Laser). The laser group received the 660 nm laser (200 mW/cm<sup>2</sup>) irradiation for 5&#xa0;min after incubation at 24&#xa0;h. After 48&#xa0;h, we added 10 &#x3bc;L CCK-8 solution to each well and detected the absorbance at 450 nm.</p>
</sec>
<sec id="s2_7">
<label>2.7</label>
<title>Animal experiment and design</title>
<p>Animal model: All BALB/c-nu mice animal procedures were approved by SPF Biotechnology Co., Ltd in our experiments. The melanoma cancer model was generated by subcutaneous injection of B16F10 cell (5&#xd7;10<sup>5</sup>) suspended in PBS into the flank region of the right back of BALB/c mice and allowed them to grow into solid tumors.</p>
<p>Biodistribution of Gel-HCeC-CaO<sub>2</sub> in B16F10 tumor-bearing mice: Mice were injected with 100&#x3bc;L Ce6, HCeC, and Gel-HCeC-CaO<sub>2</sub> after the tumor volume reached about~65 mm<sup>3</sup>. We used an <italic>in vivo</italic> imaging system (Perkin Elmer, America) to observe the mice at 0,4, and 20&#xa0;h after injection. And the major organs such as the liver, spleen, kidney, heart, lung, and tumor were excised for further imaging analysis.</p>
<p>Antitumor on orthotopic B16F10 model: When the tumor size achieved ~65 mm<sup>3</sup>, B16F10 tumor-bearing mice were randomly divided into eight groups (n=6/group): PBS (100&#x3bc;L,dark),Gel-CaO<sub>2</sub> (100&#x3bc;L,dark),HCeC (100&#x3bc;L,dark),HCeC (100&#x3bc;L,laser),HCeC (100&#x3bc;L,laser*2),Gel-HCeC-CaO<sub>2</sub> (100&#x3bc;L,dark),Gel-HCeC-CaO<sub>2</sub> (100&#x3bc;L,laser), and Gel-HCeC-CaO<sub>2</sub> (100&#x3bc;L,laser*2). The laser group was irradiated with 660 nm laser (200 mW/cm<sup>2</sup>) irradiation for 5&#xa0;min at 4&#xa0;h or 20&#xa0;h. And we recorded the body weights and tumor volumes of mice every 2 days (<xref ref-type="bibr" rid="B46">46</xref>). The tumor volumes were measured with a digital caliper and calculated as the following formula: width<sup>2</sup>&#xd7;length&#xd7;0.5.</p>
<p>Histological analysis and anti-metastatic activity of mice: The tumors of all mice were collected and subjected to the H&amp;E staining or TUNEL assays after the mice were sacrificed. We used a light microscope (Olympus, Japan) to observe the histological change. At the same time, the lungs of mice were also excised and photographed (<xref ref-type="bibr" rid="B47">47</xref>).</p>
</sec>
<sec id="s2_8">
<label>2.8</label>
<title>Quantitative polymerase chain reaction</title>
<p>The oligonucleotide primers were designed by Sangon Biotech (Shanghai, China) and listed in <xref ref-type="table" rid="T1">
<bold>Table 1</bold>
</xref>. The total RNA was extracted by TRIzol reagent and quantified by NanoDrop2000 spectrophotometer (Thermo Fisher Scientific, USA). The PrimeScript RT Master Mix and SYBR Green PCR Master Mix were used for performing the qPCR (<xref ref-type="bibr" rid="B48">48</xref>).</p>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Primer sequences of target genes for qPCR.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="left">Gene</th>
<th valign="top" align="center">Species</th>
<th valign="top" align="center">Forward primer sequence (5'-3')</th>
<th valign="top" align="center">Reverse primer sequence (5'-3')</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">&#x3b2;-actin</td>
<td valign="top" align="left">mouse</td>
<td valign="top" align="left">CCACCATGTACCCAGGCATT</td>
<td valign="top" align="left">CGGACTCATCGTACTCCTGC</td>
</tr>
<tr>
<td valign="top" align="left">TNF-&#x3b1;</td>
<td valign="top" align="left">mouse</td>
<td valign="top" align="left">GAATGAAGTGCACCCTAACAAG</td>
<td valign="top" align="left">GAGGAATGGGTTCACAAATCAG</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s2_9">
<label>2.9</label>
<title>Statistical analysis</title>
<p>The data were expressed as mean values &#xb1; SEM, including at least three biological replicates. The Student&#x2019;s t-test and one-way analysis of variance (ANOVA) were utilized to determine the statistical significance of differences among groups. Statistical values are indicated according to the following scale: &#x204e;p &lt; 0.05, &#x204e;&#x204e;p &lt; 0.01, &#x204e;&#x204e;&#x204e;p &lt; 0.001. All statistical analyses were performed by SPSS 19.0 software.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<label>3</label>
<title>Results</title>
<sec id="s3_1">
<label>3.1</label>
<title>Characterization of HCe and HCeC</title>
<p>The MCeNPs was synthesized by the microemulsion method (<xref ref-type="bibr" rid="B49">49</xref>). As shown in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure 1</bold>
</xref>, the solution was milky white in the process of magnetic stirrers, which stratified overnight. The upper popcorn liquid was a toluene organic phase containing MCeNPs and the underlying dark yellow liquid was an aqueous phase containing CeNPS-Al. Due to the lack of effective surface protection, MCNPs was agglomerated in solution and cleared by the endothelial reticular system (ERS) in the body. Therefore, HCe and HCeC were synthesized by probing the interaction between CeNPs and HA to improve the stability of MCeNPs. To measure the size distribution of HCe and HCeC, we performed the DLS. As shown in <xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>, the average diameter of HCeC was approximately 25.60 nm while HCe was about 19.86 nm, because the Ce6 molecule increased the molecular diameter of HCe. And the zeta potential of the HCeC was approximately -6mV and the HCe was -5.6mV in <xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>, owing to the presence of the carboxyl group in Ce6. To examine the structure of the HCe and HCeC, the detailed morphology was characterized by HR-TEM. Due to the protective effect of HA (<xref ref-type="bibr" rid="B50">50</xref>), we found the size of HCe and HCeC are about 2-3nm and 3-4nm, showing good dispersion in water in <xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>. The Ce<sup>3+</sup>/Ce<sup>4+</sup> ratio is crucial for the enzyme-mimetic activity, the X-ray photoelectron spectroscopy (XPS) analysis of HCe and HCeC showed high Ce<sup>3+</sup>/Ce<sup>4+</sup> ratio in <xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1D, E</bold>
</xref> and <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figures 2A&#x2013;C</bold>
</xref>. Besides, the results of Fourier transform infrared spectra (FT-IR) showed that HA was conjugated to nanoceria successfully in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure 2D</bold>
</xref>.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Characterization of HCe and HCeC. <bold>(A)</bold> DLS of HCe and HCeC. <bold>(B)</bold> Zeta potential of HCe and HCeC. <bold>(C)</bold> TEM of HCe and HCeC. <bold>(D)</bold> XPS analysis of HCe. <bold>(E)</bold> XPS analysis of HCeC. <bold>(F)</bold> Fluorescence spectra of Ce6, HCe, and HCeC. <bold>(G)</bold> UV&#x2013;vis absorption spectroscopy of Ce6, HA, HCe and HCeC. <bold>(H)</bold> Photosensitivity of HCeC. <bold>(I, J)</bold> The CAT-like activity of HCeC.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-13-1126094-g001.tif"/>
</fig>
<p>To verify that Ce6 was linked to HCe, the fluorescence spectra of Ce6, HCe, and HCeC were determined by a fluorescence spectrometer at 405 nm excitation light in <xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1F</bold>
</xref>, and the characteristic fluorescence peaks of Ce6 were between 640-690nm. Owing to the electron transfer between HCe and Ce6, HCeC showed significant fluorescence quenching compared with Ce6. The successful preparation of HCeC was validated by UV&#x2013;vis absorption spectroscopy in <xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1G</bold>
</xref>. The characteristic absorption peak of Ce6 was at 404nm, with the Q wave between 500-700nm. The absorption peak of HCeC was similar to Ce6 besides a little red shift, which indicated that Ce6 had been successfully covalently linked to HCe. To explore the stability of nanomaterial, HCe and HCeC were mixed in a series of physiological solutions (water, PBS, DMEM, DMEM+10% FBS) for 24&#xa0;h. As shown in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure 2E</bold>
</xref>, we found there were no obvious agglomeration and precipitation of HCe and HCeC. These results indicated that HA modification could improve the stability of CeNPs effectively as literature report (<xref ref-type="bibr" rid="B51">51</xref>, <xref ref-type="bibr" rid="B52">52</xref>). Besides, we found that the mass ratio of Ce to Ce6 of the HCeC is about 1:0.33 <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figures&#xa0;2F, G</bold>
</xref> and the HA modification could not affect the photosensitivity of HCeC in <xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1H</bold>
</xref>. The HCeC showed high CAT-like activity in <xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1I, J</bold>
</xref>. Therefore, we demonstrated that HA had been successfully modified on the surface of nano-sized cerium oxide and covalently bound to Ce6, which provided a foundation for further biological application.</p>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>Characterization of the Gel-HCeC-CaO<sub>2</sub> system</title>
<p>Hydrogel was a kind of polymer material that had been widely studied at present (<xref ref-type="bibr" rid="B53">53</xref>), which could be converted between liquid and solid state with a change of temperature. To show the sol-gel transition behavior of the hydrogel by the test tube inverting method (<xref ref-type="bibr" rid="B44">44</xref>), the Gel and Gel-HCeC-CaO<sub>2</sub> were liquid at -20&#xb0;C&#x2ce; 4&#xb0;C &#x2ce;25&#xb0;Cand 37&#xb0;C. As shown in <xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2A</bold>
</xref>, the liquid transformed into gel at -20&#xb0;C and 37&#xb0;C and the sol state at 4&#xb0;C and 25&#xb0;C. With the extension of the bath time at 37&#xb0;C, the hydrosol transformed into the gel phase gradually, and the rheological temperature was affected by the addition of CaO<sub>2</sub> and HCeC. The gelation time of Gel-HCeC-CaO<sub>2</sub> was approximately 9 s with the Gel needing 12 s and more time in <xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2B</bold>
</xref>. To observe the corrosion behavior of the Gel, the release experiment <italic>in vitro</italic> was performed, which showed the gel is almost completely dissolved at approximately 6&#xa0;h in <xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2C</bold>
</xref>, following zero-order kinetics. Besides, the UV&#x2013;vis absorption spectroscopy was used to investigate the photophysical properties of HCeC, Gel, Gel-CaO<sub>2</sub>, and Gel-HCeC-CaO<sub>2</sub> in <xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2D</bold>
</xref>, and the absorption peak of Gel-HCeC-CaO<sub>2</sub> was similar to HCeC, indicating that HCeC was mixed with the gel.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>Characterization of the Gel-HCeC-CaO<sub>2</sub> system. <bold>(A)</bold> The sol-gel transition behavior of Gel and Gel-HCeC-CaO<sub>2</sub> system. <bold>(B)</bold> The gelation time of Gel and Gel-HCeC-CaO<sub>2</sub>. <bold>(C)</bold> The corrosion behavior of the Gel-HCeC-CaO<sub>2</sub>. <bold>(D)</bold> The photophysical properties of HCeC, Gel, Gel-CaO<sub>2</sub>, and Gel-HCeC-CaO<sub>2</sub>. <bold>(E)</bold> The O<sub>2</sub> generation of Gel-HCeC-CaO<sub>2</sub>.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-13-1126094-g002.tif"/>
</fig>
<p>Furthermore, owing to the catalase activity of HCeC, the O<sub>2</sub> generation of Gel-HCeC-CaO<sub>2</sub> <italic>in vitro</italic> was detected. As shown in <xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2E</bold>
</xref>, the generation rate of oxygen from Gel-HCeC-CaO<sub>2</sub>(PH=7.2) was fast compared with other groups, indicating that the catalase activity of HCeC was influenced by the PH value. Owing to the catalase activity of the Gel-HCeC-CaO<sub>2</sub> being affected by PH (<xref ref-type="bibr" rid="B54">54</xref>), the catalase activity of the Gel-HCeC-CaO<sub>2</sub> was the highest under neutral conditions while reducing the catalase activity under acidic conditions. Therefore, the Gel-HCeC-CaO<sub>2</sub> could release oxygen slowly to relieve tumor hypoxia in the acidic tumor microenvironment.</p>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>
<italic>In vitro</italic> PDT of HCeC and Gel-HCeC-CaO<sub>2</sub> system</title>
<p>To detect the phototoxicity of Gel-HCeC-CaO<sub>2</sub>, cell viability was measured by CCK-8. There was almost no significant phototoxic effect observed in B16F10 cells treated with HCeC with or without irradiation in <xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>. However, the B16F10 cells treated with Gel-HCeC-CaO<sub>2</sub> (Laser) had a significant effect on B16F10 cells compared with Gel-HCeC-CaO<sub>2</sub> (Dark) in <xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>. Because the Gel-HCeC-CaO<sub>2</sub> (Laser) could release oxygen to improve the PDT efficiency, and produce a large number of <sup>1</sup>O<sub>2</sub> and ROS to kill tumor cells. Moreover, the H<sub>2</sub>O<sub>2</sub> (300 &#x3bc;M) could almost kill 50% of B16F10 cells owing to the toxicity in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure 3A</bold>
</xref>, but the H<sub>2</sub>O<sub>2</sub> (100 &#x3bc;M) had almost no effect, confirming that the toxicity of Gel-HCeC-CaO<sub>2</sub> was not caused by H<sub>2</sub>O<sub>2</sub>. To test the migration of B16F10 cells treated with Gel-HCeC-CaO<sub>2</sub> (Laser), we performed the scratch test. As shown in <xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3C</bold>
</xref>, the migration ability of B16F10 cells in the Gel-HCeC-CaO<sub>2</sub> (Laser) group was significantly lower compared with other groups. Therefore, the Gel-HCeC-CaO<sub>2</sub> (Laser) could enhance PDT efficiency and kill B16F10 cells significantly.</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>
<italic>In vitro</italic> photothermal of HCeC and biodistribution of Gel-HCeC-CaO<sub>2</sub> system. <bold>(A)</bold> The phototoxic effect of HCeC. <bold>(B)</bold> The phototoxic effect of Gel-HCeC-CaO<sub>2</sub> system. <bold>(C)</bold> The migration of B16F10 cells treated with Gel-HCeC-CaO<sub>2</sub> (Laser). <bold>(D)</bold> The biodistribution of Gel-HCeC-CaO<sub>2</sub> <italic>in vivo</italic>. <bold>(E)</bold> Fluorescence imaging of some organs (Top: liver, spleen, kidney; Bottom: heart, lung, tumor). &#x2217;p &lt; 0.05; &#x2217;&#x2217;p &lt; 0.01; &#x2217;&#x2217;&#x2217;p &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-13-1126094-g003.tif"/>
</fig>
</sec>
<sec id="s3_4">
<label>3.4</label>
<title>
<italic>In vivo</italic> biodistribution of Gel-HCeC-CaO<sub>2</sub> system</title>
<p>To show the biodistribution of Gel-HCeC-CaO<sub>2</sub> <italic>in vivo</italic>, the fluorescence of Ce6, HCeC, and Gel-HCeC-CaO<sub>2</sub> in mice was detected at 0&#xa0;h,4 h, and 20&#xa0;h post-injection. As shown in <xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3D</bold>
</xref>, only a small amount of fluorescence appeared at the tumor site in Ce6 and HCeC group whereas predominantly observed in the Gel-HCeC-CaO<sub>2</sub> group at 20&#xa0;h, suggesting that the good retention of the Gel-HCeC-CaO<sub>2</sub> in the mice. The biodistribution of the nanomaterials in mice was quantitatively analyzed in <xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3E</bold>
</xref>. Fluorescence imaging of some organs like lungs, liver, and kidneys showed that free Ce6 and HCeC were rapidly cleared over time up to 20&#xa0;h, and the Gel-HCeC-CaO<sub>2</sub> had the good retention of the tumor to improve the PDT efficiency.</p>
</sec>
<sec id="s3_5">
<label>3.5</label>
<title>
<italic>In vivo</italic> photodynamic effect of Gel-HCeC-CaO<sub>2</sub> system</title>
<p>The athymic nude mouse xenograft B16F10 model was generated for photodynamic therapy of melanoma. To examine the PDT efficiency of different materials to reduce tumor progression in the athymic nude mouse xenograft B16F10 model, 100&#x3bc;L PBS, Gel-CaO<sub>2</sub>, HCeC, Gel-HCeC-CaO<sub>2</sub> were intravenously injected into the mice at 1 week after engraftment, and the NIR irradiation (660 nm, 200 mW/cm<sup>2</sup>, 5&#xa0;min) was administered to the tumor site at 4&#xa0;h and 20&#xa0;h post-injection in the laser groups in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figures 3B, C</bold>
</xref>. The tumors of mice in each group were photographed, the Gel-HCeC-CaO<sub>2</sub> group could significantly inhibit the B16F10 tumor progression in <xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A, B</bold>
</xref>. As shown in <xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4C, D</bold>
</xref>, the HCeC and Gel-HCeC-CaO<sub>2</sub> groups showed significant tumor regression with a reduction of the tumor volume by &#x223c;42%, indicating the chemotherapy toxicity of the HCeC. The laser groups which irradiated one time could delay B16F10 tumor progression by&#x223c;69%, indicating that HCeC had obvious phototherapy toxicity. The Gel-HCeC-CaO<sub>2</sub>(Laser*2)had high tumor growth inhibition than HCeC(Laser*2), showing that Gel-HCeC-CaO<sub>2</sub> could satisfy repeat PDT therapy.</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>
<italic>In vivo</italic> photothermal effect of Gel-HCeC-CaO<sub>2</sub> system. <bold>(A, B)</bold> The tumors of mice in each group were photographed (#1: PBS; #2: Gel-CaO<sub>2</sub>; #3: HCeC; #4: Gel-HCeC-CaO<sub>2</sub>; #5: HCeC+Laser; #6: Gel-HCeC-CaO<sub>2</sub>+Laser; #7: HCeC+Laser*2; #8: Gel-HCeC-CaO<sub>2</sub>+Laser*2). <bold>(C, D)</bold> The HCeC and Gel-HCeC-CaO<sub>2</sub> showed significant tumor regression with a reduction of the tumor volume. <bold>(E)</bold> Tunnel assay of the tumor. <bold>(F)</bold> HE staining of tumor. <bold>(G)</bold> The expression of HIF-1 &#x3b1;. <bold>(H)</bold> The body weight of mice. *p &lt; 0.05; **p &lt; 0.01; ***p &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-13-1126094-g004.tif"/>
</fig>
<p>The tunnel assay confirmed that the Gel-HCeC-CaO<sub>2</sub> (Laser) group induce apoptosis of B16F10 cells <italic>in vivo</italic> in <xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4E</bold>
</xref>. Furthermore, hematoxylin and eosin (H&amp;E) staining revealed large areas of necrosis, inflammatory cell infiltration and broken blood vessels of tumor tissue in Gel-HCeC-CaO<sub>2</sub> (Laser*2) group in <xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4F</bold>
</xref>. Hypoxia-inducible factor 1 &#x3b1; (HIF-1 &#x3b1;) was an important transcriptional regulator, which was crucial for tumor progression (<xref ref-type="bibr" rid="B55">55</xref>). The Gel-HCeC-CaO<sub>2</sub> system could significantly inhibit the expression of HIF-1 &#x3b1; compared with the HCeC in <xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4G</bold>
</xref>, indicating that Gel-HCeC-CaO<sub>2</sub> could alleviate the hypoxia of the tumor microenvironment. Besides, there were no metastatic tumor nodules observed in the lungs of the mice in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure 3D</bold>
</xref>. To show the systemic toxicity of materials, we observed the body weight and histological change of mice. As shown in <xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4H</bold>
</xref>, the treatment could not change the body weight of mice. Therefore, the Gel-HCeC-CaO<sub>2</sub> (Laser) could reduce tumor progression in the athymic nude mouse xenograft B16F10 model significantly.</p>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<label>4</label>
<title>Discussion</title>
<p>Notably, the inadequate amount of oxygen generation and short-term effects of photosensitizers induced by drug metabolism and clearance in the tumor environment cannot ameliorate the aggravated stuff supply mediated by PDT consumption (<xref ref-type="bibr" rid="B10">10</xref>&#x2013;<xref ref-type="bibr" rid="B12">12</xref>), failing efficient and repeated PDT. Therefore, an efficient long-term oxygen supply and drug delivery system should be explored for PDT efficacy improvement and tumor inhibition. Herein, a prolonged oxygen-generating phototherapy hydrogel system (Gel-HCeC-CaO<sub>2</sub>) was designed to alleviate tumor hypoxia, prolong drug supply, enhance PDT efficacy, and overcome melanoma. As shown in <xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>, PSs loaded biocompatible CeNPs nanocarrier (HCeC) was synthesized by an HA-mediated self-assembly method under an alkaline environment, followed by incorporation into a thermo-sensitive hydrogel prepared by simple mixing Pluronic<sup>&#xae;</sup> F127 and F68, the FDA-approved polymers (<xref ref-type="bibr" rid="B42">42</xref>). Sufficient oxygen generation was obtained by introducing an O<sub>2</sub>-evolving agent CaO<sub>2</sub> into the hydrogel system, which could react with H<sub>2</sub>O to form H<sub>2</sub>O<sub>2</sub> and followed produce O<sub>2</sub> catalyzed by catalase-like CeNPs. The prolonged oxygen supply was achieved by the prepared hydrogel. The prepared hydrogel could limit the infiltration of H<sub>2</sub>O into the system and moderate the hydrolysis rate of CaO<sub>2</sub>, resulting in sustained hypoxia alleviation in tumor tissues. Besides, the prepared hydrogel could act as a sustained delivery system and be easily injected around the tumor, resulting in prolonged drug accumulation. The accumulated HCeC entered into tumor cells by endocytosis mediated by CD44, a targeted receptor of HA overexpressed on most of the malignant tumors, resulting in a promoted PSs cellular uptake. Synthetically, a &#x201c;once injection, repeat irradiation&#x201d; strategy was achieved through the developed hydrogel system to enhance the PDT efficiency and overcome melanoma.</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>Synthesis of the Gel-HCeC-CaO<sub>2</sub> system. The Gel-HCeC-CaO<sub>2</sub> system could alleviate tumor hypoxia microenvironment, prolong drug supply, enhance PDT efficacy, and overcome melanoma.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-13-1126094-g005.tif"/>
</fig>
</sec>
<sec id="s5" sec-type="conclusion">
<label>5</label>
<title>Conclusion</title>
<p>In this study, we prepared a Gel-HCeC-CaO<sub>2</sub> system which showed a significant phototoxic effect of B16F10 tumor by NIR irradiation. The Gel-HCeC-CaO<sub>2</sub> system showed the following advantages: (i) utilized the catalase activity of HCeC to produce O<sub>2</sub>; (ii) good retention of the HCeC in the tumor; (iii) no severe systemic toxicity; (iv) alleviate tumor hypoxia environment, meeting the repeated photodynamic therapy strategy and effectively inhibiting tumor metastasis. Therefore, we believe the Gel-HCeC-CaO<sub>2</sub> system will provide a new strategy for the treatment of melanoma, which greatly alleviates the tumor hypoxia microenvironment to improve PDT efficiency.</p>
</sec>
<sec id="s7" sec-type="data-availability">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material</bold>
</xref>. Further inquiries can be directed to the corresponding author.</p>
</sec>
<sec id="s8" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>The animal study was reviewed and approved by Centre for Diseases Prevention and Control of Eastern Theater.</p>
</sec>
<sec id="s9" sec-type="author-contributions">
<title>Author contributions</title>
<p>LZ and XL had contributed equally to this work. All authors approved the final manuscript. HL, LZ, and XL designed the study and instructed all experiments. LZ and XL carried out the data analysis and drafted the manuscript. SR, YC, and ZC assisted in performing the experiments. YM, YQ, and HL provided many suggestions on the articles and obtained funding. All authors contributed to the article and approved the submitted version.</p>
</sec>
</body>
<back>
<sec id="s10" sec-type="funding-information">
<title>Funding</title>
<p>This work was supported by research grants from the National Natural Science Foundation of China (81803173 and 81901555), Natural Science Foundation of Jiangsu Province (SBK2018040981), Incubation Project of Military Medical Science and Technology (20QNPY121), and Youth Science and Technology Project (grant no. (2022)-151).</p>
</sec>
<sec id="s11" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s12" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s13" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fonc.2023.1126094/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fonc.2023.1126094/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet_1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
</sec>
<fn-group>
<title>Abbreviations</title>
<fn fn-type="abbr">
<p>PDT, photodynamic therapy; Gel-HCeC-CaO2,oxygengenerating hydrogel loaded with hyaluronic acid-chlorin e6 modified nanoceria and calcium peroxide; Ce6, chlorin e6; HA, hyaluronic acid; CaO2, calcium peroxide; HIF-1a, hypoxiainducible factor -1a; ROS, reactive oxygen species; CeNPs, cerium nanoparticles; AOT, docusate sodium; NaOH, sodium hydroxide; DMEM, dulbecco&#x2019;s modified Eagle&#x2019;s medium; FBS, fetal bovine serum.</p>
</fn>
</fn-group>
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