Biomaterial-Based Strategies Reshape Gout Therapy: From Nanoparticles to Microneedles
核心洞察
Biomaterial-based drug delivery systems, including nanoparticles, microneedles, and hydrogel microspheres, offer targeted and sustained release to overcome the low bioavailability and systemic toxicity of conventional gout (搜索) therapies.
Microenvironment-responsive nanoparticles degrade selectively in acidic or high-oxidative joint spaces, enabling controlled anti-inflammatory payload release while scavenging reactive oxygen species.
Transdermal microneedle arrays provide minimally invasive, pain-free administration that bypasses first-pass metabolism, with fast-dissolving and swelling hydrogel designs showing efficacy in acute gout (搜索) models.
Gout (搜索), an inflammatory disease driven by hyperuricemia and monosodium urate (MSU) crystal deposition, affects millions worldwide, yet conventional pharmacotherapies—including urate-lowering agents, NSAIDs, colchicine, and uricase-based therapies—remain hampered by low bioavailability, poor specificity, systemic adverse effects, enzyme instability, immunogenicity, and short circulation half-lives. A comprehensive review published in the International Journal of Nanomedicine now highlights how biomaterial-based strategies are poised to address these limitations through advanced drug delivery systems, novel biomaterial-based drugs, and improved preclinical modeling.
The review, authored by Zhang and colleagues, provides an integrated perspective linking the pathological progression of gout (搜索) with recent advances in biomaterials, spanning nanoparticles, liposomes, hydrogels, microneedles, and bioactive scaffolds. These platforms leverage biocompatibility, biodegradability, and tunable delivery properties to improve targeting efficiency, prolong drug release, and reduce systemic toxicity.
Microenvironment-Responsive Nanoparticles Target Inflammatory Joints
Among the most promising innovations are microenvironment-responsive nanoparticle systems that exploit the unique pathological conditions of gout (搜索)-affected joints—decreased pH, reactive oxygen species (ROS) overload, and matrix metalloproteinase (MMP) activation. One notable example is a stimuli-responsive drug delivery system (BIM) based on bovine serum albumin (BSA) and manganese dioxide (MnO₂) nanoparticles. This composite material demonstrated pH-responsive release: at pH 6.0, 50% of encapsulated indomethacin was released over 12 hours, compared to only 30% at pH 7.4. In an MSU-induced acute gouty arthritis mouse model, MnO₂ nanoparticles effectively degraded ROS while indomethacin downregulated cyclooxygenase-2 (COX-2), suppressing pro-inflammatory cytokines and inhibiting macrophage polarization to the M1 phenotype.
A more advanced system, the MAGN nanogel composed of MnO₂ nanoparticles, gelatin, and BSA, leverages the affinity of BSA for secreted protein acidic and rich in cysteine (SPARC) to achieve targeted accumulation in joint synovium. MAGN senses local MMP-2 concentrations to modulate its degradation rate, enabling responsive release of berberine—a traditional Chinese medicine compound whose bioavailability is otherwise less than 1%. In animal models, MAGN significantly reduced ankle swelling and lowered expression of ROS and inflammatory cytokines IL-6, IL-1β (搜索), and TNF-α (搜索).
Immune-Shielding Platforms Overcome Uricase Limitations
Urate oxidase (UOX) offers exceptional urate-lowering efficacy but its clinical utility is severely limited by antigenicity and immunogenicity. To address this, researchers have developed immune-shielding nanoparticle systems. One approach co-loads UOX and catalase (CAT) into zeolitic imidazolate framework-8 (ZIF-8) nanoparticles, then encapsulates the composite with purified neutrophil membranes. These membranes retain surface antigens that recognize inflammatory factors such as IL-1β (搜索), TNF-α (搜索), and IL-6, enabling targeted delivery to gout (搜索) inflammation sites while simultaneously neutralizing pro-inflammatory cytokines.
An alternative strategy employs red blood cells as carriers, assembling UOX- and CAT-loaded ZIF-8 nanoparticles onto erythrocyte surfaces using tannic acid as interparticle ligands. This approach confers prolonged in vivo retention and superior immune evasion. The review notes that neutrophil membrane-coated systems may offer stronger inflammation-homing capacity for acute flare control, while red blood cell-based platforms are potentially better suited for sustained systemic urate-lowering therapy.
Transdermal Microneedles: Minimally Invasive Precision Delivery
Microneedle (MN) arrays represent a paradigm shift in gout (搜索) drug administration, offering penetration of the stratum corneum without stimulating dermal nerve endings. The review categorizes current MN platforms into three types: rapid-acting anti-inflammatory, long-acting urate-lowering, and composite functional systems.
Fast-dissolving microneedles capable of complete dissolution within five minutes of skin insertion have been developed for polydatin delivery. Using hydroxypropyl-β-cyclodextrin as a carrier, polydatin solubility increased by 10.59-fold and permeability by 8.6-fold. In MSU-induced acute gout (搜索) models, microneedles loaded with 1.6 mg of polydatin achieved therapeutic efficacy equivalent to oral colchicine at 0.5 mg/kg.
For sustained urate control, layered microneedles combining an outer carboxymethyl cellulose layer loaded with allopurinol and an inner core of uricase with calcium peroxide nanoparticles reduced serum uric acid levels to 142 μmol/L within three hours in hyperuricemia animal models, with effects sustained for up to 12 hours.
Multifunctional microneedles, such as the UAO-LPO/Col-MNs system, co-deliver uricase encapsulated in liposomes and colchicine through a three-layer design. These microneedles not only degrade uric acid but also inhibit NLRP3 inflammasome (搜索) activation and suppress the RANK/RANKL pathway to prevent osteoclast maturation and joint bone destruction.
Intestinal-Targeted Hydrogel Microspheres
Approximately one-third of total uric acid excretion occurs via the gastrointestinal tract. Core-shell hydrogel microspheres developed by Tang and colleagues, composed of a uricase-dopamine core within a calcium alginate shell, remain stable for over six hours in acidic simulated gastric fluid but degrade rapidly within one hour under intestinal conditions. In animal models, these microspheres increased intestinal uric acid excretion by 27.6%, reduced serum uric acid levels by 71%, and significantly alleviated MSU-induced inflammation and joint swelling.
Novel Biomaterial-Based Drugs
Beyond delivery systems, biomaterials themselves are being explored as active therapeutic agents. Carbon dots derived from kudzu root (PLR-CDs) and immature bitter orange (AFIC-CDs) have demonstrated xanthine oxidase (搜索) inhibition comparable to allopurinol, with additional anti-inflammatory effects through suppression of IL-1β (搜索) and TNF-α (搜索). Folic acid-modified lysozyme-protected gold nanoclusters (FLA) exhibit urate recognition capability, anti-inflammatory properties, and accelerated renal clearance without significant nephrotoxicity.
Gene-encoded anti-gout (搜索) therapeutics represent another frontier. A chimeric protein combining the IL-1 receptor antagonist (IL-1Ra) sequence with a lysine-rich peptide, assembled into spherical nanoparticles via electrostatic adsorption with PEG-COO⁻, increased IL-1β (搜索) signaling pathway inhibition by eightfold and extended the drug administration interval to 72 hours.
Translational Challenges and Animal Model Limitations
Despite these advances, the review emphasizes that current preclinical models do not adequately replicate human gout (搜索) pathology. Rodents possess urate oxidase, making stable hyperuricemia difficult to establish. While UOX knockout mouse models achieve spontaneous hyperuricemia, complete gene deletion causes pancreatic and renal dysfunction, with only approximately 40% survival at 62 weeks. Liver-specific conditional UOX knockout models improve survival to 90% but still fail to capture the characteristic recurrent flare cycles and progressive tophaceous joint destruction seen in patients.
Composite models combining high-fat diets with repeated MSU crystal injections show more severe ankle swelling and inflammatory cell infiltration, while cartilage defect models with repeated MSU injections better simulate recurrent inflammatory responses and bone destruction. However, the review concludes that future research must prioritize developing animal models that more faithfully mirror clinical gout (搜索) progression to accelerate translational success.
Long-term biological safety profiles, batch consistency, large-scale manufacturing scalability, and precise degradation kinetics inside human articular cavities remain unconfirmed for most biomaterial platforms. The authors call for future designs to integrate multi-stimuli responsive mechanisms, improve targeting specificity, and validate long-term in vivo safety before clinical conversion can be achieved.