中国神经再生研究(英文版) ›› 2021, Vol. 21 ›› Issue (5): 1764-1782.doi: 10.4103/NRR.NRR-D-24-01492

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

基于纳米粒子的新策略可为脑卒中患者带来有效治疗和疗效

  

  • 出版日期:2026-05-15 发布日期:2025-08-20
  • 基金资助:
    国家自然科学基金(82272163, 82472164)

Emerging nanoparticle-based strategies to provide therapeutic benefits for stroke

Javaria Sundus1, 2, Nashwa Amin2, 3, Irum Naz Abbasi1, 2, Fei Wu1, 2, Azhar B. Hussien1, 2, Benson OA Botchway2 , Suhong Ye4, *, Qining Yang5, *, Marong Fang1, 2, *   

  1. 1 Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, China;  2 Institute of System Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China;  3 Department of Zoology, Faculty of Science, Aswan University, Aswan, Egypt;  4 The Second Hospital of Jinhua, Jinhua, Zhejiang Province, China;  5 Department of Orthopedics, Jinhua Municipal Central Hospital, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang Province, China
  • Online:2026-05-15 Published:2025-08-20
  • Contact: Marong Fang, PhD, fangmaro@zju.edu.cn; Qining Yang, MD, jhyangqn@163.com; Suhong Ye, MD, jhyyysh@126.com.
  • Supported by:
    This work was supported by the National Natural Science Foundations of China, Nos. 82272163, 82472164 (both MF).

摘要:

神经功能恢复仍是治疗缺血性脑卒中的首要目标,但目前的治疗方法往往无法达到最佳效果。脑卒中治疗面临的最大挑战之一是如何有效地将神经保护剂通过血脑屏障输送到大脑缺血区域。血脑屏障对于保护大脑免受有害物质的伤害至关重要,但同时也限制了许多治疗化合物的通过,从而限制了它们的疗效。此综述的目的是探讨基于纳米粒子的疗法在缺血性脑卒中治疗中的新兴作用,观察它们在彻底改变药物输送、加强神经保护和促进功能恢复方面的潜力。纳米技术的最新进展促使人们开发出了专为克服 血脑屏障而设计的工程纳米粒子,从而能够将治疗药物直接靶向输送到受影响的脑区。临床前研究表明,基于纳米颗粒的疗法具有激活关键神经保护通路(如 PI3K/AKT/CREB 信号级联)的显著潜力,这些通路对神经元存活、突触可塑性和脑卒中后恢复至关重要。通过调节这些通路,纳米粒子可以减轻神经元损伤、减少炎症反应并促进组织修复。此外,纳米颗粒还具有独特的优势,它可以实现多模式治疗策略,同时针对缺血性脑卒中的多种病理机制,包括氧化应激、神经炎症和细胞凋亡。这种多方面的方法提高了治疗的整体疗效,解决了导致脑卒中相关脑损伤的复杂而又相互关联的过程。表面修饰,如用特定配体或靶向分子进行功能化,可进一步提高给药的精确性,增强靶向特异性,延长全身循环时间,从而优化治疗效果。通过将靶向给药与调节关键神经保护途径的能力相结合,纳米粒子有望改变缺血性脑卒中的治疗格局。然而,尽管临床前数据非常令人鼓舞,但要将这些进展转化为临床实践仍面临巨大挑战。未来还需要进一步的研究来完善纳米粒子的设计,优化其安全性,并确保其可扩展性,以便广泛使用。严格的临床试验对于验证其疗效、评估长期生物相容性以及解决潜在的脱靶效应至关重要。结合纳米技术、神经科学和药理学的见解,整合跨学科方法对于克服这些挑战至关重要。基于纳米粒子的疗法为创新的精准治疗奠定了基础,可显著改善脑卒中患者的预后,为脑卒中护理和神经康复的新时代铺平道路。

https://orcid.org/0000-0002-6636-4347 (Marong Fang); https://orcid.org/0009-0001-0804-7618 (Qining Yang); 
https://orcid.org/0009-0004-8879-4227 (Suhong Ye)

关键词: 血脑屏障, 给药系统, 缺血性脑卒中, 纳米医学, 纳米粒子, 神经炎症, 神经元, 神经保护, 氧化应激, 磷脂酰肌醇 3-激酶

Abstract: Functional neurological recovery remains the primary objective when treating ischemic stroke. However, current therapeutic approaches often fall short of achieving optimal outcomes. One of the most significant challenges in stroke treatment is the effective delivery of neuroprotective agents across the blood–brain barrier to ischemic regions within the brain. The blood–brain barrier, while essential for protecting the brain from harmful substances, also restricts the passage of many therapeutic compounds, thus limiting their efficacy. In this review, we summarizes the emerging role of nanoparticle-based therapies for the treatment of ischemic stroke and investigate their potential to revolutionize drug delivery, enhance neuroprotection, and promote functional recovery. Recent advancements in nanotechnology have led to the development of engineered nanoparticles specifically designed to overcome the blood–brain barrier, thus enabling the targeted delivery of therapeutic agents directly to the affected brain areas. Preclinical studies have demonstrated the remarkable potential of nanoparticle-based therapies to activate key neuroprotective pathways, such as the phosphoinositide 3-kinase/protein kinase B/cAMP response element-binding protein signaling cascade, which is crucial for neuronal survival, synaptic plasticity, and post-stroke recovery. By modulating these pathways, nanoparticles could mitigate neuronal damage, reduce inflammation, and promote tissue repair. Furthermore, nanoparticles offer a unique advantage by enabling multimodal therapeutic strategies that simultaneously target multiple pathological mechanisms of ischemic stroke, including oxidative stress, neuroinflammation, and apoptosis. This multifaceted approach enhances the overall efficacy of treatment, addressing the complex and interconnected processes that contribute to stroke-related brain injury. Surface modifications, such as functionalization with specific ligands or targeting molecules, further improve the precision of drug delivery, enhance targeting specificity, and prolong systemic circulation, thereby optimizing therapeutic outcomes. Nanoparticlebased therapeutics represent a paradigm shift for the management of stroke and provide a promising avenue for reducing post-stroke disability and improving the outcomes of long-term rehabilitation. By combining targeted drug delivery with the ability to modulate critical neuroprotective pathways, nanoparticles hold the potential to transform the treatment landscape for ischemic stroke. However, while preclinical data are highly encouraging, significant challenges remain in translating these advancements into clinical practice. Further research is needed to refine nanoparticle designs, optimize their safety profiles, and ensure their scalability for widespread application. Rigorous clinical trials are essential to validate their efficacy, assess long-term biocompatibility, and address potential off-target effects. The integration of interdisciplinary approaches, combining insights from nanotechnology, neuroscience, and pharmacology, will be critical if we are to overcome these challenges. Ultimately, nanoparticle-based therapies offer a foundation for innovative, precisionbased treatments that could significantly improve outcomes for stroke patients, thus paving the way for a new era in stroke care and neurological rehabilitation.

Key words: blood–brain barrier, drug delivery systems, ischemic stroke, nanomedicine, nanoparticles, neuroinflammation, neurons, neuroprotection, oxidative stress, phosphatidylinositol 3-kinases