# Programmable ROS modulation by nanomedicine for rheumatoid arthritis treatment

## TL;DR

This paper reviews how nanomedicine can precisely modulate reactive oxygen species to treat rheumatoid arthritis, offering new therapeutic strategies.

## Contribution

The paper systematically categorizes and evaluates ROS-modulating nanotherapeutic systems for rheumatoid arthritis.

## Key findings

- ROS-centered nanotherapies can reshape the immune microenvironment and restore redox balance in RA.
- Different nanosystems, including ROS-scavenging and responsive types, offer advantages in RA treatment.
- Challenges remain in biosafety, controllability, and clinical translation of these nanotherapies.

## Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation and progressive joint destruction. Extensive studies have demonstrated that reactive oxygen species (ROS) play a critical role in the pathogenesis and progression of RA. Imbalanced ROS not only aggravate synovial inflammation and cartilage degradation but also disrupt immune homeostasis. In recent years, nanotechnology-based strategies for regulating ROS have provided new insights into the precise treatment of RA. This review systematically summarizes ROS-centered nanotherapeutic systems applied in RA therapy, including ROS-scavenging nanosystems, ROS-responsive nanosystems, ROS-scavenging and responsive composite nanosystems, and ROS-augmenting nanosystems. Furthermore, the review highlights the advantages of ROS-modulating nanosystems in reshaping the immune microenvironment, restoring redox balance, and achieving combination therapy and theranostic integration, while also addressing challenges related to biosafety, controllability, and clinical translation. Overall, programmable ROS-modulating nanotherapeutic strategies offer new directions and theoretical foundations for the precise treatment of RA.

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•Programmable ROS modulation framed as a core strategy for RA nanotherapy.•Link ROS biology, inflammatory pathways and nanomaterial design principles.•Summarize ROS-scavenging, ROS-responsive, hybrid and ROS-augmenting systems.•Discuss translational challenges and design cues for clinical RA nanomedicine.

Programmable ROS modulation framed as a core strategy for RA nanotherapy.

Link ROS biology, inflammatory pathways and nanomaterial design principles.

Summarize ROS-scavenging, ROS-responsive, hybrid and ROS-augmenting systems.

Discuss translational challenges and design cues for clinical RA nanomedicine.