Nanozyme-Mediated Joint Homeostasis Restoration: Emerging Strategies for Arthritis Therapy

Severe oxidative stress and inflammatory cascades drive the pathological progression of rheumatoid arthritis (RA), osteoarthritis (OA), and gouty arthritis (GA). Conventional pharmacotherapies and natural enzyme interventions are frequently constrained by factors such as systemic toxicity and poor intra-articular bioavailability. In contrast, nanozymes have garnered researcher's attention by virtue of their superior physicochemical stability, cost-effectiveness, and tunable reactive oxygen species (ROS) scavenging capacities. They exhibit unique advantages in the field of arthritis therapy, featuring single-atom catalysts, efficient multi-enzyme catalytic activities, and significantly prolonged synovial retention half-lives. To bridge critical gaps in the existing review literature, this review focuses on nanozyme-mediated therapeutics for the three most common types of arthritis, systematically summarizing the latest advancements in this domain. First, the review elucidates the pathomechanisms of RA, OA, and GA to establish a therapeutic rationale. Subsequently, the article traces the evolution of nanozyme engineering designs for specific disease applications. Finally, critical barriers to clinical translation are analyzed, including long-term biosafety, pharmacokinetics, and industrial standardization. This review elucidates the therapeutic functions of nanozymes across distinct pathological microenvironments, establishing a clinical demand-driven classification framework. By mapping material-inherent catalytic properties directly to specific clinical requisites, this article provides actionable insights to bridge the translational gap between fundamental biomaterials research and clinical practice.