Nanomedicine for atherosclerosis: Molecular imaging and treatment

Cardiovascular diseases (CVDs) and the underlying process of atherosclerosis are considered to be the most frequent causes of mortality and morbidity in developed societies. Atherosclerosis constitutes a systemic, chronic and progressive inflammatory disease that is initiated by early endothelial dysfunction and is subsequently amplified by oxidative stress, lipid deposition and monocyte recruitment. An interplay occurs among diverse cells, chemoattractants, adhesion molecules and low-density lipoproteins in the subendothelium. Due to the complexity of its pathogenesis, effective therapeutic strategies have not yet been applied in routine clinical practice. With the advent of nanotechnology, nanoparticulate systems with diagnostic and therapeutic moieties for the site-specific targeting of atherosclerotic lesions as well as nanomaterials that are suitable for cardiovascular implants may offer possible solutions to certain shortfalls of current treatment regimens. This article describes the recent advances that involve different types of nanoparticles for the early detection and concurrent therapy of atherosclerotic lesions. Moreover, it provides a state-of-the-art overview of stent technology in the restoration of normal blood flow to ischemic myocardial sites and underscores its drawbacks in light of substantial nanotechnology-based improvements. Emphasis is placed on the contribution of nanomedicine to the development of novel and effective therapies for atherosclerosis, ranging from 'nanotheranostic' strategies for vulnerable plaques to the nanoporous and nanoparticulate drug-delivery platforms that have been applied to stent technology. By striking a balance between the efficacy and the potential toxicity of nanotechnology-enabled systems, new frontiers in atherosclerosis treatment will emerge.