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Nanomedicines for cardiovascular disease

Nature Cardiovascular Research volume 2, pages 351–367 (2023)Cite this article

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Abstract

The leading cause of death in the world, cardiovascular disease (CVD), remains a formidable condition for researchers, clinicians and patients alike. CVD comprises a broad collection of diseases spanning the heart, the vasculature and the blood that runs through and interconnects them. Limitations in CVD therapeutic and diagnostic landscapes have generated excitement for advances in nanomedicine, a field focused on improving patient outcomes through transformative therapies, imaging agents and ex vivo diagnostics. CVD nanomedicines are fundamentally shaped by their intended clinical application, including (1) cardiac or heart-related biomaterials, which can be functionally (for example, mechanically, immunologically, electrically) improved by incorporating nanomaterials; (2) the vasculature, involving systemically injected nanotherapeutics and imaging nanodiagnostics, nano-enabled biomaterials or tissue-nanoengineered solutions; and (3) improving the sensitivity and/or specificity of ex vivo diagnostic devices for patient samples. While immunotherapy has developed into a key pillar of oncology in the past dozen years, CVD immunotherapy and immunoimaging are recently emergent and likely to factor substantially in CVD management in the coming decade. The nanomaterials in CVD-related clinical trials and many promising preclinical strategies indicate that nanomedicine is on the cusp of greatly impacting patients with CVD. Here we review these recent advances, highlighting key clinical opportunities in the rapidly emerging field of CVD nanomedicine.

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Fig. 1: Schematic breakdown of therapeutic and diagnostic cardiovascular nanomedicine applications.
Fig. 2: Cancer nanomedicine has far outpaced cardiovascular nanomedicine by numbers of annual publications and clinical trials.
Fig. 3: Nanoimmunomedicine for CVD.
Fig. 4: Nanotheranostics for CVD.

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Acknowledgements

We gratefully acknowledge our funding sources, including the American Heart Association Transformational Project Award 18TPA34230113 and the NIH (R01 CA244491 to B.R.S. and R01HL161069-02 to E.R.E.). Correspondence and requests should be addressed to B.R.S. at smit2901@msu.edu.

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Authors and Affiliations

  1. Department of Biomedical Engineering and Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, USA

    Bryan Ronain Smith

  2. Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA

    Elazer R. Edelman

  3. Cardiovascular Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Elazer R. Edelman

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  1. Bryan Ronain Smith
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  2. Elazer R. Edelman
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Contributions

B.R.S. wrote the draft and made figures; E.R.E. made key edits and additions.

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Correspondence to Bryan Ronain Smith.

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Competing interests

E.R.E. receives research support from Abiomed and Shockwave; is a consultant to BEV, Cascade, Cipherome, Marusan Pharmaceutics, Peregrine and Tekla; serves on the boards of Butterfly, Colossal and Xenter; and is a founder of Autus, BioDevek and PanTher Therapeutics. B.R.S. declares no competing interests.

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Nature Cardiovascular Research thanks Ke Cheng, Kanyi Pu and Willem Mulder for their contribution to the peer review of this work.

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Smith, B.R., Edelman, E.R. Nanomedicines for cardiovascular disease. Nat Cardiovasc Res 2, 351–367 (2023). https://doi.org/10.1038/s44161-023-00232-y

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