Atherosclerosis nanotheranostics: a perspective from macrophages

The mortality rate of cardiovascular diseases (CVDs) has ranked number one in the world over the years. Atherosclerosis (AS), a chronic inflammatory disease, is a key pathological factor in the occurrence and development of CVDs, characterized by lipid accumulation and plaque formation in arteries. Macrophages is the critical contributor to the progression of AS, and macrophage-related pathological processes have received considerable attention as an extremely important target for the diagnosis and treatment of AS. Biomaterial-based nanotechnology offers the possibility of selective and efficient delivery of therapeutic agents to atherosclerotic macrophages, shows the potential to improve the understanding of the pathophysiology of AS, contributes to improve the therapeutic outcomes and imaging accuracy, and further minishes the risk of CVDs. This review provides a well-rounded snapshot of the features, functions, and critical roles of macrophages in the development and progression of AS, as well as the recent advances in the application of macrophage-related nanomaterials in the diagnosis and treatment of AS, with specific emphasis on the design and integration of nanomaterials for specific macrophages-manipulating. Finally, the challenges and prospects of macrophage-based nanotechnologies for the prevention and treatment of AS are also discussed in depth, aiming to inspire innovative thinking and facilitate the ever-fast development of nanomedicine for AS.