The It is widely recognized that medical nanotechnology is a promising approach to solve cancer challenges. Worldwide, cancer is the leading cause of death, accounting for nearly 10 million (or nearly one in six) deaths, according to a report published by the World Health Organization (WHO). Among the conventional cancer treatments, surgical resection, radiotherapy, and chemotherapy are the most common. The current conventional treatment for cancer kills cells indiscriminately in the focal area of the body, causing severe pain to the patient during the treatment procedure (Li et al., 2020). Drug delivery via nanomedicine carriers is a viable alternative to conventional chemotherapy which suffers from poor water solubility, poor tissue targeting, and severe systemic toxic effects (Kumstel et al., 2020). Nanomedicine carriers increase drug concentration within the target area and thus improve drug utilization and efficacy by increasing the drug concentration in the target area. As well, the nano drug carriers can be administered within the tumor vasculature, thereby reducing the drug dose and the toxic side effects on other tissues and organs.

In the world, liver cancer is the sixth most common type of cancer. Hepatocellular carcinoma (HCC) has an 18% 5-year survival rate, making it the second most lethal cancer following pancreatic cancer. Its insidious onset and insensitivity to chemotherapy make its treatment unsatisfactory (Zhang X. et al., 2016). As nanodrugs are able to increase drug bioavailability and hepatic targeting while reducing side effects on normal tissues, they offer greater possibilities for treating hepatocellular carcinoma when conventional therapies are ineffective (Bakrania et al., 2021; Elnaggar et al., 2021). In the field of targeted therapies, sorafenib (SOR) was the first systemic drug to demonstrate efficacy in patients with advanced HCC and has been used as a first-line treatment for more than 10 years. SOR alone is unlikely to achieve therapeutic expectations because of its inherent toxic side effects and the development of tumor resistance. This could be caused by the development of resistant tumor variants. In addition to traditional anticancer drugs, nanomedicines can be combined together to enhance delivery, retention, and release of these drugs into target cells and tumor tissues, thereby increasing the therapeutic effectiveness of cancer treatment. The combination of SOR and adriamycin has been proven to provide better therapeutic effects in patients with advanced hepatocellular carcinoma in clinical trials. Using a hybrid lipid-polymer nanoparticle containing a tumor-targeting peptide (iRGD), Zhang J. et al. (2016) developed a (DOX) and SOR delivery system containing iRGD (see Figure 1A). In contrast to single drug delivery, the hybrid delivery system resulted in greater bioavailability of the drug, improving the effectiveness of the anti-tumor treatment. The results of this study demonstrate that nanoparticles combined with clinical anticancer drugs are capable of enhancing anti-HCC efficacy, which is a direction of future research. In addition to the combination of nanoparticles and anticancer drugs, the combination of therapeutic nucleic acids and nanoparticles has also shown promise for application. In the research of Oh et al. (2016), DOX bound by electrostatic interaction was delivered through liposomes coated with siRNA, and the combination of DOX and siRNA inhibited tumor growth (see Figure 1B). Therefore, synergistic antitumor therapy has the potential to effectively target tumor cells and improve the antitumor effect, demonstrating its great potential. A nanodrug (HA @ PDC-DOX₂) was also developed and synthesized by Wang J. et al. (2020), consisting of peptide-adriamycin as the core and hyaluronic acid as the shell, to enhance the stability and targeting capability of PDC-DOX₂ (see Figure 1C). A new gold nanoparticle (Do-AuNP) was successfully synthesized from the extract of Dendrobium (DO), a traditional Chinese medicine. Experimental results show Do-AuNP has better anti-tumor efficiency as compared to gold nanoparticles in either vitro or in vivo, providing a new approach (Zhao et al., 2021). One of the key directions in nanomedicine research for the future will be to combine nanoparticles with molecules, therapeutic drugs or inter-nanoparticles in order to enhance the stability, therapeutic effects, and reduce the toxic effects of nanomedicines.

In addition to being the most common malignant tumor in women, breast cancer is also the leading cause of cancer deaths in women. Researchers have developed a variety of nanomedicines using a variety of materials to solve the problem of serious side effects caused by therapeutic drugs. These nanomedicines target cancer cells specifically and do not affect normal cells. It has been reported that Cheng et al. (2021) have developed a novel nanomedicine (CuQDA/IO@HA) containing copper ions and quercetin to specifically target cancer cells via CD44 and induce specific cytotoxicity in breast cancer (BRCA)-mutated cancer cells. More importantly, CuQDA/IO@HA demonstrated no significant adverse effects on normal tissues or organs, demonstrating the ability to treat cancer cells by integrating metal ions with nanomedicines. It is possible to reapply nanodrugs by integrating metal ions. A number of nanomedicines based on nucleic acids, including DNA and RNA, have been found to be particularly effective when combined with chemotherapy. To enhance the therapeutic efficacy and targeting on breast cancer, Zhan et al. (2019) developed a novel tumor-targeting nanomedicine (AS1411-T-5-FU) that was combined with 5-fluorouracil (5-FU) using DNA-based delivery systems (see Figure 2A). As a result, this nanomedicine is capable of targeting and killing breast cancer cells more effectively than 5-fluorouracil alone, showing DNA’s potential as a nanomedicine material. Nucleic acid nanodrugs, however, face considerable difficulties in clinical applications due to their poor biocompatibility and low drug loading efficiency. Alternatively, Howard et al. (2022) assembles herpes simplex virus (HSV1716) with magnetic nanoparticles in order to precisely target cancer cells through magnetic actuation (see Figure 2B), preventing antibodies from attacking the virus in vivo before it can act, allowing the virus to proliferate in cancer cells while accumulating immune cells in the tumor, It can improve the treatment effect of disseminated tumors by 50% by promoting antitumor immunity, inducing tumor shrinkage, and increasing survival in a homozygous mouse model of breast cancer. Each material has its own advantages and disadvantages, and it appears to be a promising direction for future research utilizing the advantages of the materials themselves to their fullest extent and utilizing chemical coupling as a means of circumventing their shortcomings.

It is extremely difficult to treat glioma using conventional therapy as the blood-brain barrier severely hinders the anticancer effects of chemotherapy on glioma. However, various specific transporters on the blood-brain barrier can be utilized as targets to deliver tumor drugs using targeted nanoparticle delivery systems (Deng et al., 2020).Hortelao et al. designed an experimental nanorobot which was modified by urease and constructed with SiO₂ as a shell. It can load therapeutic drugs into tumor cells for release. As a result of loading nanobots with therapeutic drugs and releasing them in the tumor area, the drug concentration in the focal area increased and the drug utilization rate improved, and the drug was also reduced as it was released into other tissues and side effects were reduced (Llopis-Lorente et al., 2019). Therefore, it is apparent that nanodrugs are more effective at breaking through the blood-brain barrier than traditional chemotherapy treatments, which offers more treatment options for those suffering from brain diseases. The benefit of this approach is that it provides a greater variety of treatment options for brain diseases and achieves a more rapid therapeutic effect. Nevertheless, drug resistance is also a problem when treating glioma with a single drug. The combination of drugs, however, has good performance in treating glioma. The synergistic effect of the combination of therapeutic drugs and siRNA can significantly improve the anticancer effect in various cancers. In an experiment conducted by Peng et al. (2018), a targeted nanocarrier carrying temozolomide (TMZ) and anti-BCL-2 siRNA was used to assess the physicochemical properties and release profile of this drug, both in vitro and in vivo (see Figure 3A). Moreover, the drug promoted targeted drug delivery and inhibited tumor growth by activating pro-apoptotic genes in cancer cells, resulting in a significant apoptotic response and prolonging patients’ survival periods. It is necessary to develop drugs for the treatment of brain diseases that are capable of crossing the blood-brain barrier, as well as to evaluate the clinical effectiveness of the drugs and to target drug resistance.

Less than 5% of pancreatic cancer patients survive 5 years after being diagnosed, making it the world’s deadliest cancer. To enhance the quality of life and prolong the survival time of patients with pancreatic cancer, Gao et al. (2020) proposed delivery of drugs by ultrasound-targeted microbubble destruction (UTMD), which has significantly improved the therapeutic effect on patients with advanced pancreatic cancer. Due to its high biological toxicity, however, it has some limitations when applied to patients who are in good physical condition because it places high demands on their physical function. As reported by Ding et al. (2020), a hybrid nanodrug was fabricated (Au/FeMOF@CPT NPs) with metal organic backbone nanoparticles (MOF) and gold nanoparticles (Au NPs) (see Figure 3B), which improved the stability of the nanodrug in the organism. It was effective because cancer cells contain high concentrations of phosphate, resulting in the drug’s complete release. Even though gold nanoparticles are one of the least toxic metal nanoparticles, high concentrations may be genotoxic, and drug safety needs to be considered as well (Desai et al., 2021a). Nanomedicines are also being investigated for their potential therapeutic applications in the treatment of tumors in other organs, including the lung (see Figure 3C) (Chi et al., 2019; Wang S. et al., 2020), the esophagus (Chen et al., 2020; Salapa et al., 2020), and the cervical region (Sadoughi et al., 2021; Venkatas and Singh, 2021). Considering nanomedicines’ excellent targeting capability, future research should focus on improving the bioavailability of drugs, increasing their concentration in tumor sites, addressing possible drug resistance, and increasing their therapeutic potential.

Our standard of living has been improving in recent years, and the lifestyle and diet structure have also been changing. As a result, the incidence of diabetes mellitus (DM) and other diseases has been increasing, while traditional hypoglycemic drugs have proved difficult to treat diabetes, causing great inconvenience to patients (Vessby et al., 2000). Additionally, diabetic patients are more likely to require a prolonged hospital stay and have a higher cost of hospitalization, particularly if they have chronic complications (Karahalios et al., 2018). For the purpose of alleviating the side effects associated with long-term insulin injections and the administration of first-line diabetes treatments, including biguanides, sulfonylureas, and glycosidase inhibitors, a variety of nanoparticle-based delivery systems have been developed to replace conventional medications (Chatzipirpiridis et al., 2015; Wang et al., 2018). According toBanerjee et al. (2020), plasmid lipocalin (pADN)-based nanodrugs were developed for treating insulin resistance in type 2 diabetes in experiments with diabetic rats (see Figure 4A). They avoided enzymatic degradation of the gene product and significantly improved insulin sensitivity for up to 6 weeks, which is an effective therapeutic method. Due to the pleiotropic nature of the secreted glucagon-like peptide (GLP), L cells have attracted the attention of researchers, as Beloqui et al. (2016) A nanostructured lipid carrier was added to L cells, and the experimental results showed that nanostructured lipid carriers can increase GLP-1 secretion in murine and human L cells, which results in increased GLP-1 secretion for diabetes treatment purposes. In order to treat diabetes, exosomes can be used as nanomaterials (see Figure 4B). It has been found that these agents are capable of influencing both glucose and lipid levels, primarily through promoting glucose metabolism, enhancing lipid metabolism, and reducing lipid deposition (Ashrafizadeh et al., 2022). Therefore, they can serve as a new strategy for the treatment of diabetes.

A major focus of current research is the use of nanomedicines to treat diabetic complications, in addition to diabetes itself. Patients with diabetes are at risk for a variety of complications, including diabetic foot, diabetic neuropathy, diabetic nephropathy, diabetic retinopathy, etc. (Desai et al., 2021b; Balogh et al., 2022) One of the most common, serious, and expensive complications of diabetes is diabetic foot. As a result of hyperglycemia and abnormal glucose metabolism, diabetic patients develop lesions, neuropathy, and infection, making diabetic foot wounds difficult to heal and leading to long-term inflammation (Tatulashvili et al., 2020). In the case of diabetic feet, conventional treatment methods, such as blood glucose control and wound debridement, fail to heal the wound in a timely manner, and once infection occurs untreated, amputation is the only option (Mariadoss et al., 2022). Therefore, a drug capable of improving poor wound healing is urgently needed for diabetic. There has been some discussion regarding the potential value of nanomaterials in wound healing and infection control in this regard (Pormohammad et al., 2021; Simos et al., 2021). The development of polymeric, metallic, and ceramic nanomaterials for the treatment of acute and chronic wounds has been found to accelerate the regeneration of damaged dermal and epidermal tissues (Parani et al., 2016). Nanoparticles of silver (AgNPs) synthesized by Varaprasad et al. (2010) are suitable for use as antimicrobial dressings and wound dressings, which represents an important advancement in the field of antimicrobial dual-ion technology. By disrupting bacterial biofilms and causing aggregation of blood cells and platelets, the peptide-modified NFRH developed by Qiu et al. (2021) may accelerate wound healing by disrupting bacterial biofilms (see Figure 4C). A growing number of diabetic patients are living in China, which has led to an increased need for treatment of diabetes and its complications, especially the severe complications of diabetes.

The pathogenesis of many diseases, including deep vein thrombosis, pulmonary embolism, and ischemic stroke, involves thrombosis (Priya et al., 2021). In clinical practice, antiplatelet agents, anticoagulants, and fibrinolytic drugs are commonly used in the treatment of thrombosis, including arterial and venous thrombosis (Loyau et al., 2018; Khoukaz et al., 2020). In contrast, traditional thrombolytic drugs have a short half-life, low bioavailability, poor targeting, and low output efficiency, and the treatment must be repeated multiple times. An efficient drug is urgently needed to combat the encroachment of thrombotic disease in patients. Researchers have thus turned their attention to the treatment of thrombosis after nanomedicines were first introduced for the treatment of oncological diseases. Worldwide, ischemic stroke is one of the leading causes of severe disability and death, posing a serious public health problem as well as an economic burden on families of patients. Blood supply to the brain from blood vessels is impeded by thrombosis, resulting in a sudden reduction in cerebral blood flow caused by a series of pathological changes. These changes ultimately lead to cerebral ischemia, which can result in severe disability and even death (Ma et al., 2021). Consequently, a variety of nanomedicines have been developed with the goal of improving the effectiveness and precision of thrombosis treatments (Su et al., 2020). Timely and effective thrombolytic therapy is of great clinical significance, and nanomedicines such as liposomes, polymer nanoparticles, and magnetic nanoparticles offer great potential (Liu et al., 2018). Furthermore, Xu et al. (2019) developed a dextran-derived polymeric nanoparticle-based nanocarrier (tP-NP-rtPA/ZL006e) for simultaneous delivery of tissue fibrinogen and dextran-derived polymeric nanoparticles (see Figure 5A). Compared to conventional free drugs, this nanodrug reduced the ischemic area more effectively in in vitro and in vivo experiments. By contrast, the small extracellular vesicle (sEV)-based drug delivery system developed by Loch-Neckel et al. (2022) is endogenous nanovesicles that have excellent targeting capabilities and are naturally biocompatible (see Figure 5B). These devices are more advantageous in treating CNS diseases, providing greater benefits for the treatment of Alzheimer’s disease, brain tumors and other diseases, as they can cross the blood-brain barrier and target specific nerve cells. Nanomaterials have also shown great potential when combined with traditional Chinese medicine. Salvianolic acid B(SAB), a water-soluble phenolic acid derived from Salvia miltiorrhiza, a traditional Chinese medicine. According to Zhang S. et al. (2022), the RR@SABNPs are a brain-targeted bionanopharmaceutical made of bovine serum albumin nanoparticles that contain salvianolic acid and functionalized red blood cell membranes that contain salvianolic acid. In addition to stability, it is biocompatible as well. Influenced by single-cell organisms, Zhang et al.propose a strategy to use programmed alternating magnetic fields to enable amoeboid microrobots to more effectively deliver thrombolytic drugs and unblock embolic vessels (Zhang et al., 2023).

Furthermore, in a mouse model of infarction, the drug significantly scavenged excess reactive oxygen species and reduced infarct size. It is anticipated that the number of patients who suffer from severe disability or even death as a result of thrombosis will be greatly reduced.