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已发表论文
用于周围神经再生的中药工程递送系统：挑战、进展与未来展望
Authors Zhang R , Gu M, Ma R, Li R, Xu S, Xu Z
Received 28 August 2025
Accepted for publication 10 November 2025
Published 18 November 2025 Volume 2025:19 Pages 10195—10224
DOI https://doi.org/10.2147/DDDT.S563805
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Leonidas Panos
Ruirui Zhang,1,2,* Miao Gu,3,* Rui Ma,2 Rong Li,1 Shijie Xu,1 Zhipeng Xu4
1Jiangsu Province Key Laboratory of Medical Science and Laboratory Medicine, Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, People’s Republic of China; 2Department of Anatomy, School of Medicine, Jiangsu University, Zhenjiang, 212013, People’s Republic of China; 3Hebei Key Laboratory of Nerve Injury and Repair, Chengde Medical University, Chengde, Hebei, People’s Republic of China; 4Department of Urology, Affiliated People’s Hospital of Jiangsu University, The First People’s Hospital of Zhenjiang, Zhenjiang, Jiangsu, 212002, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ruirui Zhang, Email zrr812124246@163.com Zhipeng Xu, Email xuzhipeng880315@sina.com
Abstract: Peripheral neuropathy (PN), characterized by sensory, motor, and autonomic dysfunction, presents a significant therapeutic challenge owing to its diverse etiologies, dynamic spatiotemporal injury microenvironment, and impermeable blood-nerve barrier (BNB). The current treatment is mainly palliative and symptom-focused, and fails to solve the core pathological complexity, including the heterogeneity of nerve injury, the conflicting phases of inflammation, repair, and fibrosis, and the imbalance of the microenvironment in chronic conditions such as diabetes. Chinese herbal medicine (CHM) has multiple benefits including neuroprotective, anti-inflammatory, anti-oxidant, and microenvironmental regulation. However, its clinical translation is hindered by poor bioavailability, non-targeted biodistribution, BNB exclusion, and physicochemical mismatches in multicomponent formulations. Preclinical studies suggest that engineered delivery systems could emerge as a transformative solution to these limitations. Nanocarriers penetrate the BNB via diffusion or ligand-mediated targeting, offering spatiotemporal control through a stimulus-responsive design. Hydrogels align their degradation processes with nerve regeneration and correct the imbalanced microenvironments. Degradable membranes offer localized, sustained release, whereas functionalized nerve conduits address structural defects and improve functional recovery beyond autograft limitations. Despite promising preclinical efficacy, clinical translation faces significant hurdles, including long-term biocompatibility concerns, inconsistent scalability in manufacturing, dosage optimization balancing efficacy and cytotoxicity, dependence on external stimuli, and a lack of standardized regulatory frameworks. Overcoming these challenges requires interdisciplinary collaboration to advance intelligent multifunctional designs, scalable production, and rigorous validations. Based on compelling preclinical data, engineered CHM delivery systems are hypothesized to have enormous potential to transform PN management from palliative care to restorative treatment and establish a new framework in precision neurology.
Keywords: peripheral neuropathy, Chinese herbal medicine, CHM, engineered delivery systems
1Jiangsu Province Key Laboratory of Medical Science and Laboratory Medicine, Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, People’s Republic of China; 2Department of Anatomy, School of Medicine, Jiangsu University, Zhenjiang, 212013, People’s Republic of China; 3Hebei Key Laboratory of Nerve Injury and Repair, Chengde Medical University, Chengde, Hebei, People’s Republic of China; 4Department of Urology, Affiliated People’s Hospital of Jiangsu University, The First People’s Hospital of Zhenjiang, Zhenjiang, Jiangsu, 212002, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ruirui Zhang, Email zrr812124246@163.com Zhipeng Xu, Email xuzhipeng880315@sina.com
Abstract: Peripheral neuropathy (PN), characterized by sensory, motor, and autonomic dysfunction, presents a significant therapeutic challenge owing to its diverse etiologies, dynamic spatiotemporal injury microenvironment, and impermeable blood-nerve barrier (BNB). The current treatment is mainly palliative and symptom-focused, and fails to solve the core pathological complexity, including the heterogeneity of nerve injury, the conflicting phases of inflammation, repair, and fibrosis, and the imbalance of the microenvironment in chronic conditions such as diabetes. Chinese herbal medicine (CHM) has multiple benefits including neuroprotective, anti-inflammatory, anti-oxidant, and microenvironmental regulation. However, its clinical translation is hindered by poor bioavailability, non-targeted biodistribution, BNB exclusion, and physicochemical mismatches in multicomponent formulations. Preclinical studies suggest that engineered delivery systems could emerge as a transformative solution to these limitations. Nanocarriers penetrate the BNB via diffusion or ligand-mediated targeting, offering spatiotemporal control through a stimulus-responsive design. Hydrogels align their degradation processes with nerve regeneration and correct the imbalanced microenvironments. Degradable membranes offer localized, sustained release, whereas functionalized nerve conduits address structural defects and improve functional recovery beyond autograft limitations. Despite promising preclinical efficacy, clinical translation faces significant hurdles, including long-term biocompatibility concerns, inconsistent scalability in manufacturing, dosage optimization balancing efficacy and cytotoxicity, dependence on external stimuli, and a lack of standardized regulatory frameworks. Overcoming these challenges requires interdisciplinary collaboration to advance intelligent multifunctional designs, scalable production, and rigorous validations. Based on compelling preclinical data, engineered CHM delivery systems are hypothesized to have enormous potential to transform PN management from palliative care to restorative treatment and establish a new framework in precision neurology.
Keywords: peripheral neuropathy, Chinese herbal medicine, CHM, engineered delivery systems