How can we make nanomedicine work where it is most needed—at the bedside of critically ill patients? Most nanomedicines are designed and tested under healthy or mildly altered physiological conditions, yet their clinical use targets diseases marked by massive inflammation, tissue damage, and immune dysregulation, such as sepsis in the intensive care unit (ICU). To explore how such disease states reshape nanoparticle behavior, we studied poly(lactic-co-glycolic acid) (PLGA) nanoparticles with different poly(ethylene glycol) (PEG) coatings during life-threatening infection. We found that C-reactive protein (CRP), a hallmark of the acute-phase response, becomes a dominant corona component in septic plasma—adsorbing to PEGylated particles and rewiring their biological identity. Our research indicates a central challenge in translating nanomedicine into critical care: disease-driven plasma proteomes shape nanoparticle behavior. Understanding which inflammation-induced factors, such as CRP, constitute treatable traits could enable personalized nanomedicines that adapt to the patient's inflammatory state rather than being defeated by it. In other words, if we want "nano on the ICU," we must design with the disease in mind.
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Professor Dr. Alexandra K. Kiemer
Vorsitzende der DPhG Landesgruppe Saar
