Engineering MnPt Bimetallic Nanozymes for Cascade Enzymatic Therapy and Enhanced Radio-Immunotherapy

The immunosuppressive tumor microenvironment (TME) promotes resistance to radiation therapy, substantially limiting the efficacy of radioimmunotherapy. Here, we report a hyaluronic acid (HA)-coated manganese-platinum (MnPt) bimetallic nanozyme (HD@MnO₂) that integrates enzymatic cascade initiation with cGAS-STING pathway activation to facilitate radioimmunotherapy for breast cancer treatment. The HD@MnO₂ features a cationic MnO₂ core sequentially modified with HA and cisplatin, enabling CD44-targeted delivery and improved biocompatibility. Leveraging the reversible valence cycling of Mn and Pt in the TME, HD@MnO₂ offers multienzyme-like activity, which collectively enhances H₂O₂ utilization, depletes glutathione, and promotes O₂ generation. These cascade reactions combined with radiotherapy effectively trigger bursts of ROS production, disrupt redox homeostasis, and induce immunogenic cell death. Concurrently, released Mn^{2 +} activates the cGAS-STING pathway, thereby boosting innate immunity. The combination of these effects promotes dendritic cell maturation and increases CD8⁺ T cell infiltration, thereby establishing a radiotherapy-immune mutual amplification loop. Both in vitro and in vivo experiments demonstrated that HD@MnO₂ markedly eliminates primary tumors and suppresses metastatic tumors by overcoming radioresistance and eliciting potent systemic antitumor immunity. Overall, this approach offers a promising strategy for addressing the conventional limitations of radioimmunotherapy.