ABSTRACT
Rheumatoid arthritis (RA) is a chronic inflammatory and autoimmune disease that manifests in the synovium of joints, hence causing severe functional limitations. The imbalance of pro-inflammatory cytokines and anti-inflammatory cytokines plays a key role in the pathogenesis of RA. The treatment options only suppress inflammatory symptoms and not the irreversible joint damage. Thus, the disease's chronic nature and off-target therapy often lead to serious adverse side effects. Unlike conventional RA therapy, target-to-treat nanostrategies promise to increase stability, specificity, and bioavailability of therapeutic agents in the inflamed tissue and hence enhance their efficiency, while reducing the risk of well-known systemic side effects. Active nanostrategies focus on the identification of effector ligands to target specific and selective cellular receptors by the nanocarrier. Depending on the cell of interest, several studies have reported the use of an Folic acid, hyaluronic acid, or cyclic Arg-Gly-Asp peptide conjugated in nanocarriers for effector ligand-mediated targeting of the synovium.
