Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Adv Drug Deliv Rev. 2024 Apr;207:115194. doi: 10.1016/j.addr.2024.115194. Epub 2024 Feb 10.
Autoimmune disorders have risen to be among the most prevalent chronic diseases across the globe, affecting approximately 5-7% of the population. As autoimmune diseases steadily rise in prevalence, so do the number of potential therapeutic strategies to combat them. In recent years, fundamental research investigating autoimmune pathologies has led to the emergence of several cellular targets that provide new therapeutic opportunities. However, key challenges persist in terms of accessing and specifically combating the dysregulated, self-reactive cells while avoiding systemic immune suppression and other off-target effects. Fortunately, the continued advancement of nanomedicines may provide strategies to address these challenges and bring innovative autoimmunity therapies to the clinic. Through precise engineering and rational design, nanomedicines can possess a variety of physicochemical properties, surface modifications, and cargoes, allowing for specific targeting of therapeutics to pathological cell and organ types. These advances in nanomedicine have been demonstrated in cancer therapies and have the broad potential to advance applications in autoimmunity therapies as well. In this review, we focus on leveraging the power of nanomedicine for prevalent autoimmune disorders throughout the body. We expand on three key areas for the development of autoimmunity therapies - avoiding systemic immunosuppression, balancing interactions with the immune system, and elevating current platforms for delivering complex cargoes - and emphasize how nanomedicine-based strategies can overcome these barriers and enable the development of next-generation, clinically relevant autoimmunity therapies.
自身免疫性疾病已成为全球最普遍的慢性疾病之一,影响约 5-7%的人口。随着自身免疫性疾病的发病率稳步上升,针对这些疾病的潜在治疗策略的数量也在增加。近年来,对自身免疫病理学的基础研究导致了几个细胞靶点的出现,为新的治疗机会提供了可能。然而,在获得和专门针对失调、自身反应性细胞的同时避免全身免疫抑制和其他脱靶效应方面,仍然存在关键挑战。幸运的是,纳米医学的持续进步可能为解决这些挑战提供策略,并将创新的自身免疫疗法推向临床。通过精确的工程和合理的设计,纳米药物可以具有多种物理化学性质、表面修饰和载体,从而能够将治疗药物特异性靶向病理细胞和器官类型。这些在癌症治疗中的纳米医学进展具有广泛的潜力,可以推进自身免疫疗法的应用。在这篇综述中,我们专注于利用纳米医学的力量来治疗全身常见的自身免疫性疾病。我们扩展了自身免疫疗法发展的三个关键领域——避免全身免疫抑制、平衡与免疫系统的相互作用以及提高现有复杂载体的输送平台——并强调了基于纳米医学的策略如何克服这些障碍,为下一代具有临床相关性的自身免疫疗法的发展铺平道路。
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