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REVIEW
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Antibacterial sonodynamic nanomedicine: mechanism, category, and applications

Shuanglong Yi1 ,  Yao Gao2 ,  Luodan Yu1* ,  Yu Chen2*
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1 Department of Radiology, Shanghai Institute of Thoracic Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2 Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai, China
BMT 2025 , 6(1), 24–39; https://doi.org/10.12336/biomatertransl.2025.01.003
Submitted: 25 April 2024 | Revised: 8 July 2024 | Accepted: 4 March 2025 | Published: 25 March 2025
Copyright © 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution–NonCommercial–ShareAlike 4.0 License.
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Abstract

Sonodynamic therapy (SDT) has emerged as a cutting-edge strategy for combating multidrug-resistant bacterial infections. Unlike conventional antibiotics, SDT leverages the generation of reactive oxygen species during the treatment process to inflict multifaceted damage on bacterial cells, thereby significantly reducing the likelihood of developing drug resistance. Compared to other physical sterilisation methods, such as ultraviolet irradiation, SDT offers enhanced tissue penetration, making it particularly suitable for addressing deep-seated infections, including osteomyelitis. Despite its significant advantages, the clinical translation of SDT for antibacterial applications faces several challenges. This review discusses the fundamental mechanisms of SDT, with a focus on phenomena such as cavitation-induced reactions and piezocatalytic generation of reactive oxygen species. Furthermore, it provides a comprehensive analysis of various sonosensitisers used in SDT, emphasising their potential to enhance therapeutic outcomes in areas such as infected wound healing, bone regeneration, and the mitigation of deep tissue inflammation. While SDT shows great promise in addressing multidrug-resistant bacterial infections, further research and development are essential to overcome existing limitations and unlock its full clinical potential.

Keywords
antibacterial application
reactive oxygen species
sonodynamic therapy
sonosensitisers
Funding
This study was financially supported by National Natural Science Foundation of China (Nos. 52072393 and 32271457), Shanghai Shuguang Program (No. 21SG39), and Young Elite Scientists Sponsorship Program by CAST (YESS) (No. 2022-2024QNRC001).
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Conflict of interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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