Targeted drug delivery systems for rheumatoid arthritis: advancing precision medicine in autoimmune therapies

Autoimmune diseases (ADs) require targeted therapies to address the limitations of conventional immunosuppressive treatments. This review highlights recent advances in drug delivery systems (DDS), with particular focus on nanomedicine applications for ADs treatment, primarily rheumatoid arthritis. Nanocarriers, including liposomes, polymer micelles, and biomimetic nanoparticles, facilitate both passive and active targeting to inflamed tissues and immune cells. Stimuli-responsive designs further improve drug release precision within pathological microenvironments. Key biological barriers, such as the blood-brain barrier and gastrointestinal tract, can be overcome through ligand modification and microneedle technologies. Promising cell-specific strategies include macrophage polarization, neutrophil modulation, and synovial cell targeting, all demonstrating efficacy in preclinical studies. Subcellular targeting approaches offer additional mechanistic precision. While significant progress has been made, challenges remain in scalability, safety, and regulatory approval. Future research directions should focus on AI-driven material design, personalized medicine via single-cell profiling, and enhanced cross-disciplinary collaboration. DDS represent a transformative approach to ADs therapy, combining precision targeting with therapeutic efficacy to address critical unmet clinical needs.