Dissolving microneedles for autoimmune disease therapy: mechanisms, applications and challenges

Autoimmune diseases (AIDs) arise from dysregulated immune responses against self-antigens, leading to tissue damage, disability and increased mortality. Current therapies are often limited by severe adverse effects and poor patient adherence. As an emerging transdermal delivery platform, dissolving microneedle (DMN) offers a promising alternative by effectively penetrating the stratum corneum, enabling painless administration, and allowing the controlled release of biomacromolecule drugs. Given the advantages of this delivery system, this review first outlines the pathogenesis of AIDs and the limitations of existing clinical therapies. It then explores the physiological basis and therapeutic benefits of DMNs in AIDs treatment. Recent advances in the application of DMNs for representative AIDs are systematically summarized, covering key findings in small-molecule drugs, biologics, and combination therapies. Finally, the review discusses the developmental prospects and translational challenges of DMN technology and proposes strategic recommendations to accelerate its transition from preclinical research to clinical practice, with the ultimate goal of advancing DMN-based therapies for AIDs.