Move to Nano-Arthrology: Targeted Stimuli-Responsive Nanomedicines Combat Adaptive Treatment Tolerance (ATT) of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is one of the most popular chronic autoimmune diseases characterized with persistent synovial inflammation and bone destruction. Although considerable developments have been gained in clinical treatment of RA, the major drawback to RA therapy stems from the adaptive treatment tolerance (ATT) following the long-term drug use, which causes compromised efficacy, sustained drug dose increase, and severe adverse events. To address these challenges, it is of great significance to put forward innovative therapeutic approaches for RA treatment. Nowadays, developments of nanotechnology-based nanomedicines (NMs) for RA are in progress. Multifunctional NMs with targeted stimuli-responsive features have been one of the central concepts in designing more accessible formulations for efficient RA treatment. These NMs are able to postpone RA progression effectively, because of their delivery and on-demand release of medicaments at targeted sites in response to external or internal stimuli related to the RA pathophysiology without obvious adverse side-effects on the normal tissues. Therefore, NMs have gained interest from pre-clinical research scientists as well as clinical doctors worldwide. Herein, the authors highlight the recent attempts of targeted stimuli-responsive NMs for RA therapy in the last 5 years. The described progresses may pave the way to novel and highly effective RA NMs.