Targeted delivery of antioxidants to the myocardium using nanoscale carriers: a modern approach to reducing ischemic-reperfusion injury

Coronary heart disease remains one of the leading causes of death worldwide. Myocardial ischaemia-reperfusion injury, the underlying cause of сoronary heart disease, involves the excessive formation of reactive oxygen species, which leads to myocardial oxidative damage. The most logical way to combat excess ROS is to use antioxidants, which have been shown to be effective in experimental studies. However, appropriate targeting delivery methods are needed for the systemic use of antioxidant-based drugs in a clinical setting. This review discusses the mechanisms of ROS generation and action in cardiac сoronary heart disease, as well as the consequences of oxidative damage. The authors present the principles of targeted antioxidant delivery using both passive and active methods involving ligands that are specific to ischaemic tissue, such as targeted homing peptides. Analysis of the results of the various studies presented in this review shows that delivery using such specific ligands may increase the bioavailability of antioxidants and the cardioprotective efficacy of drugs based on them. In the future, the use of artificial intelligence to design high-affinity targeted peptides may open new possibilities for personalized therapy for coronary heart disease. Thus, the development of targeted drug delivery systems represents one of the most promising strategies for improving the effectiveness of treatment for myocardial ischemia-reperfusion injury.

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