Sundus Javaria, Amin Nashwa, Abbasi Irum Naz, Wu Fei, Hussien Azhar B, Botchway Benson Oa, Ye Suhong, Yang Qining, Fang Marong
Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, China.
Institute of System Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Neural Regen Res. 2025 Jun 19. doi: 10.4103/NRR.NRR-D-24-01492.
Functional neurological recovery remains the primary objective when treating ischemic stroke. However, current therapeutic approaches often fall short of achieving optimal outcomes. One of the most significant challenges in stroke treatment is the effective delivery of neuroprotective agents across the blood-brain barrier to ischemic regions within the brain. The blood-brain barrier, while essential for protecting the brain from harmful substances, also restricts the passage of many therapeutic compounds, thus limiting their efficacy. In this review, we summarizes the emerging role of nanoparticle-based therapies for the treatment of ischemic stroke and investigate their potential to revolutionize drug delivery, enhance neuroprotection, and promote functional recovery. Recent advancements in nanotechnology have led to the development of engineered nanoparticles specifically designed to overcome the blood-brain barrier, thus enabling the targeted delivery of therapeutic agents directly to the affected brain areas. Preclinical studies have demonstrated the remarkable potential of nanoparticle-based therapies to activate key neuroprotective pathways, such as the phosphoinositide 3-kinase/protein kinase B/cAMP response element-binding protein signaling cascade, which is crucial for neuronal survival, synaptic plasticity, and post-stroke recovery. By modulating these pathways, nanoparticles could mitigate neuronal damage, reduce inflammation, and promote tissue repair. Furthermore, nanoparticles offer a unique advantage by enabling multimodal therapeutic strategies that simultaneously target multiple pathological mechanisms of ischemic stroke, including oxidative stress, neuroinflammation, and apoptosis. This multifaceted approach enhances the overall efficacy of treatment, addressing the complex and interconnected processes that contribute to stroke-related brain injury. Surface modifications, such as functionalization with specific ligands or targeting molecules, further improve the precision of drug delivery, enhance targeting specificity, and prolong systemic circulation, thereby optimizing therapeutic outcomes. Nanoparticlebased therapeutics represent a paradigm shift for the management of stroke and provide a promising avenue for reducing post-stroke disability and improving the outcomes of long-term rehabilitation. By combining targeted drug delivery with the ability to modulate critical neuroprotective pathways, nanoparticles hold the potential to transform the treatment landscape for ischemic stroke. However, while preclinical data are highly encouraging, significant challenges remain in translating these advancements into clinical practice. Further research is needed to refine nanoparticle designs, optimize their safety profiles, and ensure their scalability for widespread application. Rigorous clinical trials are essential to validate their efficacy, assess long-term biocompatibility, and address potential off-target effects. The integration of interdisciplinary approaches, combining insights from nanotechnology, neuroscience, and pharmacology, will be critical if we are to overcome these challenges. Ultimately, nanoparticle-based therapies offer a foundation for innovative, precisionbased treatments that could significantly improve outcomes for stroke patients, thus paving the way for a new era in stroke care and neurological rehabilitation.
在治疗缺血性中风时,功能神经恢复仍然是主要目标。然而,目前的治疗方法往往难以达到最佳效果。中风治疗中最重大的挑战之一是将神经保护剂有效输送穿过血脑屏障,到达脑内的缺血区域。血脑屏障虽然对于保护大脑免受有害物质侵害至关重要,但也限制了许多治疗性化合物的通过,从而限制了它们的疗效。在本综述中,我们总结了基于纳米颗粒的疗法在缺血性中风治疗中的新兴作用,并研究它们在革新药物递送、增强神经保护和促进功能恢复方面的潜力。纳米技术的最新进展已促成了专门设计用于克服血脑屏障的工程纳米颗粒的开发,从而能够将治疗剂直接靶向递送至受影响的脑区。临床前研究已证明基于纳米颗粒的疗法在激活关键神经保护途径方面具有显著潜力,例如磷酸肌醇3激酶/蛋白激酶B/环磷酸腺苷反应元件结合蛋白信号级联反应,这对于神经元存活、突触可塑性和中风后恢复至关重要。通过调节这些途径,纳米颗粒可以减轻神经元损伤、减少炎症并促进组织修复。此外,纳米颗粒具有独特优势,能够实现多模式治疗策略,同时针对缺血性中风的多种病理机制,包括氧化应激、神经炎症和细胞凋亡。这种多方面的方法提高了治疗的整体疗效,应对了导致中风相关脑损伤的复杂且相互关联的过程。表面修饰,如用特定配体或靶向分子进行功能化,进一步提高了药物递送的精确性,增强了靶向特异性并延长了全身循环时间,从而优化了治疗效果。基于纳米颗粒的疗法代表了中风管理的范式转变,并为减少中风后残疾和改善长期康复结果提供了一条有前景的途径。通过将靶向药物递送与调节关键神经保护途径的能力相结合,纳米颗粒有潜力改变缺血性中风的治疗格局。然而,虽然临床前数据非常令人鼓舞,但将这些进展转化为临床实践仍面临重大挑战。需要进一步研究来完善纳米颗粒设计、优化其安全性并确保其可扩展性以实现广泛应用。严格的临床试验对于验证其疗效、评估长期生物相容性以及解决潜在的脱靶效应至关重要。如果我们要克服这些挑战,整合跨学科方法,结合纳米技术、神经科学和药理学的见解将至关重要。最终,基于纳米颗粒的疗法为创新的、精准的治疗提供了基础,有望显著改善中风患者的治疗结果,从而为中风护理和神经康复的新时代铺平道路。
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