How Advanced is Nanomedicine to Treat Atherosclerosis? A Comprehensive Review of the Literature

Atherosclerosis (AS) is a major underlying cause of cardiovascular disease. Rupture of unstable atherosclerotic plaques can induce severe acute cardiovascular events and sudden cardiac death. Therefore, developing targeted interventional therapies for atherosclerotic plaques is clinically important to improve cardiovascular mortality. With the advancement of nanomedicine, nanomaterials have demonstrated great potential in atherosclerosis treatment due to their unique compositional/structural features, synthesis strategies, and surface modifications. Based on the pathological characteristics of atherosclerotic plaques, the design and preparation of stimulus-responsive, surface-functionalized, and conditionally-released nanomaterials have become an important approach to achieving precise intervention for atherosclerotic lesions. Considering the pathological features of different cell types involved in AS progression, this review describes the targeting strategies, structural and functional designs, and potential mechanisms of action of targeted nanotherapies in the treatment of atherosclerosis. By summarizing representative recent studies in detail, we reveal the intrinsic interactions and relationships between current targeted nanotherapies and atherosclerotic plaques. Finally, this review provides an outlook on the future application of nanomaterials by presenting key scientific questions that have not yet been addressed, to advance the clinical translation of targeted nanotherapies for atherosclerosis.