Zhao Fang, Hu Zeyu, Li Gejing, Liu Min, Huang Qiong, Ai Kelong, Cai Xiong
Institute of Innovation and Applied Research in Chinese Medicine and Department of Rheumatology of First Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, P.R. China.
Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, 410078, P.R. China.
Bioact Mater. 2025 May 2;50:603-639. doi: 10.1016/j.bioactmat.2025.04.026. eCollection 2025 Aug.
Angiogenesis is critical from early development through the progression of life-threatening diseases. In rheumatoid arthritis (RA), angiogenesis is markedly heightened and undergoes aberrant changes that exacerbate the progression of synovitis. However, the intricate mechanisms underlying these changes remain poorly understood. Despite the development of numerous anti-angiogenic agents, their clinical efficacy is often compromised by adverse effects and the emergence of adaptive resistance, leading to disease relapse or progression. Nanomedicine has gained significant attention owing to its excellent biocompatibility, precise biological targeting, and enhanced therapeutic outcomes. Anti-angiogenic nanoagents have shown transformative potential in treating cancer and retinal diseases. Nevertheless, a comprehensive review addressing the fundamental mechanisms of anti-angiogenic nanoagents in RA has yet to be undertaken. Herein, this review provides an in-depth description of the unique structural and functional aspects of pathological angiogenesis in RA and its negative consequences. The mechanisms of pro-angiogenic mediators contributing to RA angiogenesis are further explored. Subsequently, biological activities of nanomedicines for the treatment of RA are summarized. Finally, the cutting-edge developments in the anti-angiogenic nanoagents of RA engineered based on these mechanisms and bioactivities are outlined. A helpful introduction to anti-angiogenic strategies for treatment of RA, which may offer novel perspectives for the development of nanoagents, is opening a new horizon in the fight against RA.
从早期发育到威胁生命的疾病进展过程中，血管生成至关重要。在类风湿关节炎（RA）中，血管生成显著增强，并发生异常变化，加剧滑膜炎的进展。然而，这些变化背后的复杂机制仍知之甚少。尽管已开发出多种抗血管生成药物，但其临床疗效常因不良反应和适应性耐药的出现而受到影响，导致疾病复发或进展。纳米医学因其优异的生物相容性、精确的生物靶向性和增强的治疗效果而备受关注。抗血管生成纳米制剂在治疗癌症和视网膜疾病方面已显示出变革性潜力。然而，尚未对RA中抗血管生成纳米制剂的基本机制进行全面综述。在此，本综述深入描述了RA中病理性血管生成的独特结构和功能方面及其负面后果。进一步探讨了促成RA血管生成的促血管生成介质的机制。随后，总结了用于治疗RA的纳米药物的生物活性。最后，概述了基于这些机制和生物活性设计的RA抗血管生成纳米制剂的前沿进展。对抗RA血管生成策略的有益介绍可能为纳米制剂的开发提供新的视角，为对抗RA开辟了新的视野。
