Nanoengineered therapy aiming at the etiology of rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovitis and damage of cartilage and bone. Many efforts have been made in the past to develop chemical and biological drugs for the RA treatment, which achieve certain therapeutic effects, but the alleviation of RA symptom is hard to last and a long-time drug administration leads to toxic side effects. Incorporating drugs into nanomaterials to create multifunctional nanomedicine can not only improve drug loading and release behaviors, but also adjust the distribution of drugs in the body and target them to specific cells. Further integrating the latest understanding about the RA pathogenesis into the rational design of nanomedicine will provide targets and opportunities for RA treatment. This review presents two main mechanisms of nanoengineered treatment design for RA, the regulation of pathogenic cells (e.g., macrophage, B cells, regulatory T cells and synovial cells) and elimination of extracellular factors (including cytokines, cell-free DNA and hyperproliferative blood vessels), highlighting the rational design and further therapeutic applications.