Yuhang Feng,1 Jiaojiao Chen,1 Xiaoqing Guo,1 Mengting Qin,1 Shengnan Wang,1 Dailiang Jiang,1 Xiaoming Liu,2 Ling Mao1 

1Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China; 2Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China

Correspondence: Xiaoming Liu, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People’s Republic of China, Email Xiaoming_liu@hust.edu.cn Ling Mao, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People’s Republic of China, Tel +86 15172314891, Email maoling@mail.hust.edu.cn

Abstract: Cardiovascular and cerebrovascular diseases are the leading causes of mortality worldwide, with atherosclerosis being the primary etiology. Despite its prevalence, atherosclerosis remains inadequately controlled by conventional therapeutic interventions. The unique physicochemical properties of nanomedicine offer new hope for the treatment of atherosclerosis. Macrophages are now understood to play a pivotal role in the progression of atherosclerosis, acting as both pathogenic factors and potential therapeutic targets. The inherent plasticity of macrophages significantly influences disease progression, suggesting that modulating macrophage function or abundance could provide a viable strategy to intervene in the atherosclerotic process. This review comprehensively examines the targeted delivery and controlled release of nanoparticles, providing an in-depth analysis of both passive and active targeting strategies, as well as the controlled release of therapeutic agents in response to the specific microenvironment of atherosclerotic plaques and external stimuli such as light and sound. The role of biomimetic nanomedicines in the treatment of atherosclerosis, primarily those utilizing macrophage membrane coatings and exosomes, is discussed. Finally, the current challenges facing nanomedicine in atherosclerosis treatment are analyzed, emphasizing the need for future research to investigate its mechanisms of action in depth and optimize related strategies to harness its therapeutic potential.

Keywords: nanomedicine, macrophage, atherosclerosis, targeted delivery, responsive strategies