Bioinspired nano-delivery systems for botanical drugs and TCM enhance multi-target atherosclerosis therapy

Atherosclerosis (AS), the primary pathological basis of global cardiovascular disease mortality, is undergoing a paradigm shift from risk factor management toward precise plaque intervention. Current therapeutic strategies often fail to simultaneously target lipid deposition, chronic inflammation, and endothelial dysfunction. Traditional Chinese Medicine (TCM) offers multi-target therapeutic potential, yet its active components often suffer from low oral bioavailability and inadequate tissue targeting. This review explores nanotechnological strategies to overcome these limitations, enabling more effective and precise plaque intervention.

This article systematically reviewed common types of TCM nano-formulations, including nanoemulsions, nanosuspensions, and nanoliposomes. It discussed recent advances in their application to atherosclerosis. Furthermore, the review analyzed bioinspired nano-delivery systems, such as platforms integrating anti-AS peptides, HDL, platelet membranes, or macrophage membranes with natural metabolites possessing anti-inflammatory or antioxidant activities. The focus was on mechanisms like reducing cholesterol levels, promoting cholesterol efflux, and driving macrophage repolarization.

The review highlighted that the "nanoization" of Traditional Chinese Medicine (TCM) significantly improves the bioavailability and stability of botanical drug components, while reducing toxic side effects compared to conventional preparations. These advanced delivery systems preserve the "multi-target, multi-level" characteristics inherent to TCM therapy, effectively addressing issues such as low oral bioavailability and inadequate tissue targeting of active metabolites.

Bioinspired nano-delivery systems, including those incorporating anti-AS peptides or cell membranes (e.g., HDL, platelet, macrophage), exert anti-AS effects through mechanisms including reducing cholesterol levels, promoting cholesterol efflux, and driving macrophage repolarization towards an anti-inflammatory phenotype. Successful application depends on precise control of nanoparticle size and rational delivery-system design. This approach not only enhances drug solubility and stability but also improves therapeutic efficacy and reduces toxicity while maintaining the natural pharmacodynamic profile.