Zhang Mi, Hu Wenhui, Cai Chenhui, Wu Yu, Li Jianmei, Dong Shiwu
Department of Biomedical Materials Science, College of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China.
Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Mater Today Bio. 2022 Feb 21;14:100223. doi: 10.1016/j.mtbio.2022.100223. eCollection 2022 Mar.
Inflammatory arthritis is a major cause of disability in the elderly. This condition causes joint pain, loss of function, and deterioration of quality of life, mainly due to osteoarthritis (OA) and rheumatoid arthritis (RA). Currently, available treatment options for inflammatory arthritis include anti-inflammatory medications administered via oral, topical, or intra-articular routes, surgery, and physical rehabilitation. Novel alternative approaches to managing inflammatory arthritis, so far, remain the grand challenge owing to catastrophic financial burden and insignificant therapeutic benefit. In the view of non-targeted systemic cytotoxicity and limited bioavailability of drug therapies, a major concern is to establish stimuli-responsive drug delivery systems using nanomaterials with on-off switching potential for biomedical applications. This review summarizes the advanced applications of triggerable nanomaterials dependent on various internal stimuli (including reduction-oxidation (redox), pH, and enzymes) and external stimuli (including temperature, ultrasound (US), magnetic, photo, voltage, and mechanical friction). The review also explores the progress and challenges with the use of stimuli-responsive nanomaterials to manage inflammatory arthritis based on pathological changes, including cartilage degeneration, synovitis, and subchondral bone destruction. Exposure to appropriate stimuli induced by such histopathological alterations can trigger the release of therapeutic medications, imperative in the joint-targeted treatment of inflammatory arthritis.
炎症性关节炎是老年人残疾的主要原因。这种疾病会导致关节疼痛、功能丧失和生活质量下降，主要是由于骨关节炎（OA）和类风湿性关节炎（RA）。目前，炎症性关节炎的可用治疗选择包括通过口服、局部或关节内途径给药的抗炎药物、手术和物理康复。由于灾难性的经济负担和微不足道的治疗益处，迄今为止，管理炎症性关节炎的新型替代方法仍然是一项巨大的挑战。鉴于药物疗法的非靶向全身细胞毒性和有限的生物利用度，一个主要问题是建立使用具有开-关切换潜力的纳米材料的刺激响应药物递送系统用于生物医学应用。本综述总结了依赖于各种内部刺激（包括氧化还原、pH值和酶）和外部刺激（包括温度、超声、磁、光、电压和机械摩擦）的可触发纳米材料的先进应用。该综述还探讨了基于病理变化（包括软骨退变、滑膜炎和软骨下骨破坏）使用刺激响应纳米材料治疗炎症性关节炎的进展和挑战。由这种组织病理学改变引起的适当刺激的暴露可以触发治疗药物的释放，这在炎症性关节炎的关节靶向治疗中至关重要。
