ATP-modulatory biomaterials: Design strategies and medical applications.

Adenosine triphosphate (ATP) is the central energy currency in cells, driving essential processes such as biosynthesis, transport, motility, and signal transduction. The dysregulation of ATP homeostasis is closely linked to many pathological conditions, including cancer (through the Warburg effect and extracellular ATP signaling), neurodegenerative diseases characterized by mitochondrial dysfunction, ischemia-induced cell death, and impaired tissue regeneration. Among the strategies being explored in their treatment, ATP-responsive and energy-regulating biomaterials have emerged as innovative platforms for precisely modulating pathological microenvironments and cellular metabolism. This review examines ATP-modulating biomaterials by categorizing them into four major classes: ATP-responsive materials, energy-conversion materials, ATP-functionalized materials and ATP-detection materials. It summarizes the mechanisms underlying dynamic ATP fluctuations in various diseases and their biomedical implications, with a focus on oncology, antibacterial therapy, neurodegenerative disorders, and tissue repair. By integrating perspectives from materials science, nanotechnology, and biomedicine, the review highlights key challenges, such as biocompatibility, specificity, and translational barriers, while proposing future research directions to advance ATP-based biomaterials toward improved therapeutic outcomes.