Review Article

Application of targeted therapy strategies with nanomedicine delivery for atherosclerosis

Le-chun Ou1,2, Shan Zhong1,2, Jing-song Ou3,4,5,6,7, Jin-wei Tian1,2
1 Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
2 The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150086, China
3 Division of Cardiac Surgery, Heart Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
4 National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, China
5 NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, China
6 Guangdong Provincial Engineering and Technology Center for Diagnosis and Treatment of Vascular Diseases, Guangzhou 510080, China
7 Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou 510080, China
Correspondence to: Jing-song Ou: oujs@mail.sysu.edu.cn, Jin-wei Tian: tianjinweidr2009@163.com,
DOI: 10.1038/s41401-020-0436-0
Received: 29 January 2020
Accepted: 9 May 2020
Advance online: 26 May 2020

Abstract

Atherosclerosis (AS) is the main pathological cause of coronary heart disease (CHD). Current clinical interventions including statin drugs can effectively reduce acute myocardial infarction and stroke to some extent, but residual risk remains high. The current clinical treatment regimens are relatively effective for early atherosclerotic plaques and can even reverse their progression. However, the effectiveness of these treatments for advanced AS is not ideal, and advanced atherosclerotic plaques—the pathological basis of residual risk—can still cause a recurrence of acute cardiovascular and cerebrovascular events. Recently, nanomedicine-based treatment strategies have been extensively used in antitumor therapy, and also shown great potential in anti- AS therapy. There are many microstructures in late-stage atherosclerotic plaques, such as neovascularization, micro-calcification, and cholesterol crystals, and these have become important foci for targeted nanomedicine delivery. The use of targeted nanoparticles has become an important strategy for the treatment of advanced AS to further reduce the residual risk of cardiovascular events. Furthermore, the feasibility and safety of nanotechnology in clinical treatment have been preliminarily confirmed. In this review, we summarize the application of nanomedicine delivery in the treatment of advanced AS and the clinical value of several promising nanodrugs.
Keywords: coronary heart disease; advanced atherosclerosis; vulnerable plaque; nanoparticles; targeted therapy; drug delivery

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