Re-directing nanomedicines to the spleen: A potential technology for peripheral immunomodulation

Modulation of peripheral immune cells in the spleen plays a key role in many life-threatening conditions such as stroke. Immune cell changes can lead to the excessive release of pro-inflammatory cytokines into the circulation and preferential loss of innate immune cells which can further exacerbate tissue damage and predispose patients to infectious complications. Reversing these processes represents an attractive treatment strategy and has shown to have beneficial effects in animal models of ischemic stroke, sepsis, traumatic brain injury (TBI) as well as myocardial infraction (MI). However, systemic interventions are often challenging to deliver due to the non-selective broad range of action of many treatments. More selective targeted treatment approaches are therefore desirable. The spleen is considered a natural filtration site for many nanomaterials due to the spontaneous tendency of this organ to filter blood-borne molecules. This selective targeting of nanomaterials to the spleen therefore offers considerable potential in the management of many conditions affected by peripheral inflammation. In this review, we will explore the key nanomaterials-related parameters that mediate splenic targeting and how these could influence the actual localization and function of nanomaterials once in the spleen. We aim to emphasize the potential of utilising nanomaterials as selective tools for peripheral immunomodulation to accelerate clinical translation.