Recent progress in therapeutic strategies and biomimetic nanomedicines for rheumatoid arthritis treatment

ABSTRACT

Introduction

Rheumatoid arthritis (RA) is an autoimmune systemic disease in which inflammatory and immune cells accumulate in inflamed joints. Researchers aimed at the characteristics of RA to achieve the effect of treating RA through different therapeutic strategies, and have used various endogenous materials to design drug-loaded nanoparticles that can target RA by binding to cell adhesion molecules or chemokines. In some cases, the nanoparticles can respond to the characteristics of the microenvironment.

Areas covered

This article reviews the recent advances in the treatment of RA from two aspects of therapeutic strategies and delivery strategies. Therapeutic strategies mainly include neutralization of inflammatory factors, promotion of inflammatory cell apoptosis, ROS scavenger, immunosuppression, and bone tissue repair. The drug delivery strategy is mainly described from two aspects: chemically functionalized biomimetic nanoparticles and endogenous nanoparticles.

Expert opinion

Biomimetic NPs may be effective drug carriers for targeted RA treatment. NPs can reduce the clearance of mononuclear phagocytes, prolong the blood circulation time, and improve the targeting ability. With the deepening of research, more and more biomimetic NPs have entered the clinical trial stage. However, safe and scalable preparation methods are needed to improve their clinical applicability.

KEYWORDS:

• Rheumatoid arthritis
• therapeutic strategy
• biomimetic nanomedicines
• combination therapy
• inflammatory microenvironment

Article highlights

• The onset to recovery of RA is a complex process that requires a combination of multiple strategies for treatment.

• Compared with traditional therapeutic drugs, biomimetic nanomedicines has obvious advantages, including targeted therapy, controlled release, and reduced toxicity, which is a promising targeted therapy for RA.

• Provide a general overview of current therapeutic strategies for RA.

• Inspired by tumor therapy, promoting inflammatory cell apoptosis to restore the balance of the inflammatory microenvironment is an expected targeted therapy for RA.

• According to the characteristics of RA autoimmune disease, immunotherapy is a therapeutic strategy worthy of attention from the perspective of immunogenicity.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (81803478, 2018), the Key Project of Application and Basic Research of Southwest Medical University (2021ZKZD016, 2021), and the Special Support Project for Young Talents of Southwest Medical University (2020-2022).