• Nanoparticles enable molecular targeting of vulnerable atherosclerotic plaques • Functionalized systems target endothelial, macrophage, and foam-cell markers • Theranostic nanoparticles couple plaque imaging with targeted drug delivery • Nanoplatforms move molecular targeting toward clinically focused interventions Atherosclerosis remains a major global health burden, with current diagnostic and therapeutic approaches limited in detecting and treating rupture-prone plaques. Traditional techniques such as Invasive Coronary Angiography (ICA), Fractional Flow Reserve (FFR), and Coronary Computed Tomography Angiography (CCTA) provide essential anatomical and physiological insights but primarily identify obstructive lesions, overlooking biologically unstable plaques that precipitate acute events. Nanomedicine introduces a transformative paradigm by enabling molecularly targeted diagnosis and therapy at the nanoscale. Engineered nanoparticles—organic, inorganic, and carbon-based—can traverse endothelial barriers, accumulate in atherosclerotic sites, and deliver therapeutic or imaging agents with exceptional precision. Functionalized systems targeting endothelial adhesion molecules (VCAM-1, ICAM-1), macrophage receptors (SR-A, CD44, MARCO), and foam-cell markers enable both site-specific drug delivery and real-time molecular imaging. Integration of nanoparticle theranostics with advanced imaging modalities and computational models such as CFD and AI-assisted FFR-CT may allow non-invasive visualization of plaque vulnerability and personalized treatment planning. By bridging diagnostic imaging and targeted therapy, nanotechnology offers a powerful platform for predictive and preventive cardiovascular care, positioning molecular nanomedicine at the forefront of next-generation atherosclerosis management.
Simos et al. (Fri,) studied this question.