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Hypoxia is a critical factor for restricting photodynamic therapy (PDT) of tumor, and it becomes increasingly severe with increasing tissue depth. Thus, the relief of deep tumor hypoxia is extremely important to improve the PDT efficacy. Herein, tumor microenvironment (TME)‐responsive size‐switchable hyaluronic acid‐hybridized Ru nanoaggregates (HA@Ru NAs) were developed via screening reaction temperature to alleviate deep tumor hypoxia for improving the tumor‐specific PDT by the artful integration multiple bioactivated chemical reactions in situ and receptor‐mediated targeting (RMT). In this nanosystem, Ru NPs not only enabled HA@Ru NAs to have near infrared (NIR)‐mediated photothermal/photodynamic functions, but also could catalyze endogenous H2O2 to produce O2in situ. More importantly, hyaluronidase (HAase) overexpressed in the TME could trigger disassembly of HA@Ru NAs via the hydrolysis of HA, offering the smart size switch capability from 60 to 15 nm for enhancing tumor penetration. Moreover, the RMT characteristics of HA ensured that HA@Ru NAs could specially enter CD44‐overexpressed tumor cells, enhancing tumor‐specific precision of phototherapy. Taken together these distinguishing characteristics, smart HA@Ru NAs successfully realized the relief of deep tumor hypoxia to improve the tumor‐specific PDT. [ABSTRACT FROM AUTHOR]

Herein, we describe an energy balance strategy between fluorescence and photoacoustic effects by sulfur substitution to transform existing hemicyanine dyes (Cy) into optimized NIRF/PA dual ratiometric scaffolds. Based on this optimized scaffold, we reported the first dual‐ratio response of nitroreductase probe AS‐Cy‐NO2, which allows quantitative visualization of tumor hypoxia in vivo. AS‐Cy‐NO2, composed of a new NIRF/PA scaffold thioxanthene‐hemicyanine (AS‐Cy‐1) and a 4‐nitrobenzene moiety, showed a 10‐fold ratiometric NIRF enhancement (I773/I733) and 2.4‐fold ratiometric PA enhancement (PA730/PA670) upon activation by a biomarker (nitroreductase, NTR) associated with tumor hypoxia. Moreover, the dual ratiometric NIRF/PA imaging accurately quantified the hypoxia extent with high sensitivity and high imaging depth in xenograft breast cancer models. More importantly, the 3D maximal intensity projection (MIP) PA images of the probe can precisely differentiate the highly heterogeneous oxygen distribution in solid tumor. Thus, this study provides a promising NIRF/PA scaffold that may be generalized for the dual ratiometric imaging of other disease‐relevant biomarkers. [ABSTRACT FROM AUTHOR]