Biocatalytic cascade reactions for management of diseases

Biocatalytic cascade reactions, which evolve from the confinement of multiple enzymes within living cells, represent a promising strategy for disease management. Using tailor-made nanoplatforms, reactions induced by multiple enzymes and/or nanozymes can be precisely triggered at pathogenic sites. These promote further cascade reactions that generate therapeutic species prompting effective therapeutic outcomes with minimal side effects. Over the past few years, this approach has seen widespread applications in disease management. This review attempts to critically assess and summarize the recent advances in the use of biocatalytic cascade reactions for the management of diseases. Emphasis is placed on the design of cascade catalytic systems of high efficiency and selectivity and the implementation of specific cascade processes that respond to the endogenous substances produced in the pathological processes. The various types of biocatalytic cascade reactions are outlined according to the timeline of the catalytic steps through a series of reported examples. The challenges and outlook in the field are also discussed to encourage the further development of personalized treatments based on biocatalytic cascade reactions.