Nanocatalytic medicine: pathological chemical microenvironments as regulation targets for fundamental solutions of major chronic diseases

Abstract

Major chronic diseases, including cancer, cardiovascular and neurodegenerative disorders, diabetes, and non-infectious inflammations, are fundamentally driven by dysregulated pathological chemical microenvironments characterized by oxidative stress, hypoxia, acidosis, protein misfolding, and abnormal carbohydrate and lipid metabolism. These aberrant chemical milieus not only drive pathogenesis but also create a pathological ‘soil’ that supports disease progression and confers therapeutic resistance. Traditional strategies predominantly target cellular components, overlooking this fundamental chemical basis. Nanocatalytic medicine has recently emerged as a novel paradigm that directly targets these pathological chemical microenvironments through controlled in-situ catalytic reactions. Rationally designed nanocatalysts enable precise regulation of disease-associated chemicals, including generating cytotoxic reactive oxygen species for tumor therapy, scavenging excessive oxidants to alleviate inflammatory damage, catalyzing oxygen production to relieve hypoxia, and treating biomolecular aggregates in neurodegenerative diseases. This Review delineates the chemical hallmarks of major diseases, elucidates nanocatalytic strategies for their regulation, and proposes design principles for optimizing nanocatalytic medicines. By positioning pathological chemical microenvironments as fundamental therapeutic targets, nanocatalytic medicine offers an innovative and powerful chemical toolbox for treating major chronic diseases.