Magneto-NIR-II-Programmed Cascade Nanozymes Unlocking Blood-Brain Barrier Translocation and Autophagic Resistance in Glioblastoma.

Glioblastoma (GBM) remains a highly aggressive central nervous system malignancy, and its treatment is hindered by poor drug accumulation across the blood-brain barrier (BBB) and autophagy-mediated repair. To address these barriers, rare-earth-doped Nd0.02Fe2.98S4@HA nanozymes (NFSH) are constructed as magneto-NIR-II-programmed cascade nanozymes for trans-BBB delivery, multimodal imaging, and ferroptosis amplification. Hyaluronic acid (HA)-mediated CD44 targeting and oriented magnetic field-enhanced BBB permeability promote tumor enrichment, while Nd3+ doping endows NFSH with strengthened superparamagnetism, near-infrared second window (NIR-II) photodynamic activity, and NIR-II fluorescence capability. Under alternating magnetic field (AMF) and NIR-II laser stimulation, NFSH activates catalase-, peroxidase-, glutathione oxidase-, and nicotinamide adenine dinucleotide (NADH) oxidase-like cascade catalysis, which amplifies reactive oxygen species (ROS) production, consumes glutathione, and induces ferroptosis. In the acidic tumor microenvironment, AMF further promotes H2S release, disrupts lysosomal autophagic degradation, and aggravates mitophagy inhibition through NADH depletion-mediated ATP deficiency. This cascade mechanism enhances ferroptosis and reshapes the tumor immune microenvironment by relieving hypoxia and promoting M2-to-M1 macrophage polarization. In addition, NFSH enables NIR-II fluorescence and T2-weighted magnetic resonance imaging for real-time visualization of treatment. This strategy provides an integrated trans-BBB theranostic platform for autophagy-suppressed ferroptosis therapy against GBM.