Nano-conjugation of small molecule modulators of protein aggregation: Enhancing the therapeutic precision

Protein aggregation is a central hallmark of several neurodegenerative and systemic diseases, including Alzheimer's, Parkinson's, cataract and type 2 diabetes. Consequently, targeting protein aggregation is emerging as a promising therapeutic strategy for these diseases. Small molecule modulators have exhibited considerable potential in stabilizing native protein conformations and promoting the dissolution of toxic aggregates, leading to delayed disease progression. Some also target proteostatic pathways, promoting clearance of misfolded proteins to prevent further aggregation. Despite being promising, their clinical efficacy often faces challenges due to poor bioavailability, limited stability, and lack of specificity. Recent advances in nanotechnology have introduced nano-conjugation as a potential strategy for maximizing the therapeutic efficacy of these small molecule modulators. By ensuring targeted delivery, increased availability, improved stability and controlled tissue release, nano-conjugation has not only overcome the limitations but also acts as a future pathway to precision medicine in protein aggregation diseases. The present review article provides a comprehensive overview of small molecule modulators of protein aggregation and explores how nano-conjugation enhances their therapeutic efficacy. Moreover, it highlights emerging clinical trials and explores future directions in the application of nano-conjugated small molecule modulators as a potential treatment strategy for protein aggregation diseases.