Nanomedicine‐Based Therapeutics for Myocardial Ischemic/Reperfusion Injury

Abstract

Myocardial ischemic/reperfusion (IR) injury is a global cardiovascular disease with high mortality and morbidity. Therapeutic interventions for myocardial ischemia involve restoring the occluded coronary artery. However, reactive oxygen species (ROS) inevitably impair the cardiomyocytes during the ischemic and reperfusion phases. Antioxidant therapy holds great promise against myocardial IR injury. The current therapeutic methodologies for ROS scavenging depend predominantly on administering antioxidants. Nevertheless, the intrinsic drawbacks of antioxidants limit their further clinical transformation. The use of nanoplatforms with versatile characteristics greatly benefits drug delivery in myocardial ischemic therapy. Nanoplatform‐mediated drug delivery significantly improves drug bioavailability, increases therapeutic index, and reduces systemic toxicity. Nanoplatforms can be specifically and reasonably designed to enhance molecule accumulation at the myocardial site. The present review initially summarizes the mechanism of ROS generation during the process of myocardial ischemia. The understanding of this phenomenon will facilitate the advancement of innovative therapeutic strategies against myocardial IR injury. The latest developments in nanomedicine for treating myocardial ischemic injury are then discussed. Finally, the current challenges and perspectives in antioxidant therapy for myocardial IR injury are addressed.

N‐n‐butyl haloperidol iodide mediates cardioprotection via regulating AMPK/FoxO1 signalling

“…However, these systems are severely disrupted during I/R, which contributes to excessive ROS production and leads to the initial myocardial reperfusion injury 33 . Thus, enhancing the activity of antioxidative enzymes may be a good strategy to decrease the oxidative stress‐elicited reperfusion damage 34,35 . Our previous work showed that F 2 protected against H/R model‐evoked oxidative injury in CMECs and myocytes 21,22 .…”

“…33 Thus, enhancing the activity of antioxidative enzymes may be a good strategy to decrease the oxidative stress-elicited reperfusion damage. 34,35 Our previous work showed that F 2 protected against H/R model-evoked oxidative injury in CMECs and myocytes. 21,22 In agreement with these results, we found that the in vivo I/R-induced oxidative injury was also significantly alleviated by F 2 pretreatment.…”

Polymeric Nanoparticles for Drug Delivery

“…As a consequence, the heart initiates a self-healing mechanism termed ventricular remodeling, involving the formation of fibrotic scar tissue. This process gradually induces a weakening of heart muscles, resulting in a progressive decline in muscle strength that ultimately leads to congestive heart failure and death. , Thus, there is a strong incentive for drug-delivery vehicles, including polymeric nanoparticles, to more efficiently deliver cardioprotective drugs directly into the infarcted myocardium and cardiovascular system for the diagnosis, treatment and ultimate prevention of heart failure. − Oxygen therapy via sustained delivery of oxygen following myocardial infarction can effectively rescue cardiac cells and restore cardiac function . Recently, Guan et al engineered an oxygen-releasing core–shell polymeric nanoparticle to address the current limitations of oxygen delivery in treating myocardial infarctions .…”

Exosomes-Mediated Signaling Pathway: A New Direction for Treatment of Organ Ischemia-Reperfusion Injury

“…However, due to the complex pathologic factors of I/R injury, traditional treatment strategies such as blood pressure control, detumescence, and dehydration are of limited effectiveness [19,20]. Recently, advanced therapies such as ischemic preconditioning, ischemic post-treatment, antioxidant, hypothermia, and stem cell therapy have emerged as potential treatments for I/R injury [21]. Ischemic preconditioning (IPC) is considered as an effective treatment strategy for central nervous system diseases.…”