Helicobacter pylori (HP) is a helical-shaped bacterium that inhabits the human stomach and is associated with various pathologies, including gastritis, gastric ulcers, and gastric cancer. HP infection is the largest contributor to gastric cancer, and approximately 90% of non-cardia gastric cancers are related to HP infection. As HP gastritis is an infectious disease, eradicating HP is an effective measure to prevent gastric cancer. Traditional triple therapy has demonstrated limited efficacy due to the emergence of antibiotic resistance and disruption of the intestinal microbiota. Sonodynamic therapy is an innovative nonantibiotic approach that utilizes a sonosensitizer to generate reactive oxygen species in response to ultrasound, effectively targeting pathogenic microorganisms; recent advancements have highlighted its potential for the treatment of HP infection. This article reviews recent developments in ultrasound-assisted biomaterials designed to combat HP while simultaneously preserving intestinal microecology. Furthermore, it discusses the integrated mechanisms underlying both the anti-HP effects and the maintenance of intestinal microecology. These strategies provide novel insights into overcoming the limitations associated with traditional antibiotic therapies and establish a foundation for future clinical applications.

There are several limitations to the application of nanoparticles in the treatment of cancer, including their low drug loading, poor colloidal stability, insufficient tumor penetration, and uncontrolled release of the drug. Herein, gelatin/laponite (LP)/doxorubicin (GLD) nanoparticles are developed by crosslinking LP with gelatin for doxorubicin delivery. GLD shows high doxorubicin encapsulation efficacy (99%) and strong colloidal stability, as seen from the unchanged size over the past 21 days and reduced protein absorption by 48-fold compared with unmodified laponite/doxorubicin nanoparticles. When gelatin from 115 nm GLD reaches the tumor site, matrix metallopeptidase-2 (MMP-2) from the tumor environment breaks it down to release smaller 40 nm LP nanoparticles for effective tumor cell endocytosis. As demonstrated by superior penetration in both in vitro three-dimensional (3D) tumor spheroids (138-fold increase compared to the free drug) and in vivo tumor models. The intracellular low pH and MMP-2 further cause doxorubicin release after endocytosis by tumor cells, leading to a higher inhibitory potential against cancer cells. The improved anticancer effectiveness and strong in vivo biocompatibility of GLD have been confirmed using a mouse tumor-bearing model. MMP-2/pH sequentially triggered anticancer drug delivery is made possible by the logical design of tumor-penetrating GLD, offering a useful method for anticancer therapy.