2025, Vol. 29 ›› Issue (34): 7431-7438

Antioxidant nanomedicine-mediated targeted therapy for myocardial ischemia-reperfusion injury

Wu Qingyun1, 2, Su Qiang1   

Abstract: BACKGROUND: Excessive reactive oxygen species accelerate myocardial injury during myocardial ischemia and reperfusion. Antioxidant therapies are effective but have limitations such as low bioavailability and poor target specificity. Nanomedicines, with their advantages of precise targeting and prolonged efficacy, show a broad application prospect in myocardial protection.
OBJECTIVE: To summarize the pathways of reactive oxygen species production during myocardial ischemia and the latest advances in nanomedicine for the treatment of myocardial ischemic injury.
METHODS: We searched CNKI and PubMed databases for relevant literature on antioxidant nanomedicine-mediated targeted therapy for myocardial ischemia- reperfusion injury, using “nano, nanomedicine, nanomaterials, nanotechnology, myocardial ischemia reperfusion injury, oxidative stress, reactive oxygen species” as Chinese search terms and “nanostructures, nanomedicine, nanomaterials, nanotechnology, myocardial ischemia reperfusion injury, oxidative stress, reactive oxygen species” as English search terms. The search time limit was from August 2019 to August 2024. Totally 65 articles were included in the analysis by reading the titles and abstracts of the literature for preliminary screening and excluding those with low relevance to the title of the literature.
RESULTS AND CONCLUSION: The buildup of high levels of reactive oxygen species is a key factor in myocardial ischemia-reperfusion injury. These reactive oxygen species, generated from various sources, can disrupt the metabolic processes of substances and energy, ultimately leading to apoptosis or necrosis of cardiomyocytes and causing significant damage to cardiac tissue. As a result, removing or reducing reactive oxygen species has become an important therapeutic approach to effectively prevent myocardial ischemia-reperfusion injury. Traditional medications often have short half-lives, low bioavailability, and lack targeted delivery. Additionally, the chelation effects of the liver and spleen, along with the continuous blood flow in the myocardial region, significantly impair the expected efficacy of these clinical drugs. Nanomedicines present a promising solution to these challenges and have opened new avenues for treating ischemic diseases. Carefully designed nanoparticles can facilitate targeted drug delivery, greatly increasing the concentration and retention of drugs in damaged myocardial areas, thereby enhancing therapeutic outcomes. Moreover, as carriers of antioxidants, growth factors, or cell therapies, nanomedicines effectively reduce oxidative stress and promote the repair and regeneration of cardiomyocytes, offering hope for restoring myocardial function.

Key words: antioxidant, nanomedicine, conventional drug, myocardial ischemia-reperfusion injury, acute myocardial infarction, oxidative stress, reactive oxygen species, targeted therapy, engineered vascular material