Nanomaterial-mediated multidimensional regulation of the bone microenvironment: a precise therapeutic strategy for bone metabolic imbalance

With the advancement of global population aging, the incidence of skeletal diseases (e.g. osteoporosis, fractures, and osteoarthritis) in clinical diagnosis increases and poses a serious threat to human health. Skeletal diseases usually occur as a result of disturbed cellular metabolism in a specific period or environment. The bone microenvironment, as an important physiological environment of bone tissue, consists of various cell types, and cell-cell interactions play a decisive role in the biological behavior and metabolic regulation of bone cells. Disorders of the bone microenvironment can exacerbate bone diseases. Conventional therapeutic for skeletal diseases often suffer from poor efficacy, low targeting, and side effects. Therefore, a new therapeutic strategy should be developed urgently to improve the existing deficiencies. With the continuous advancement of nanomedicine, the application of nanomaterials provides new research perspectives and application value for the treatment of skeletal diseases. With their unique physicochemical properties, nanomaterials can directly or indirectly mediate the bone microenvironment to regulate the bone metabolic process through self-regulation, drug carriers, and in vivo scaffolds. All the above strategies are extensively explored in this study. In this paper, we systematically summarize the nanomaterials currently used in the clinical treatment of bone diseases and discuss the application strategies of nanomaterials to regulate the bone microenvironment and thus bone metabolism. Moreover, we evaluated the challenges faced by nanomaterials in the clinical treatment of bone diseases. We aim to provide basic theories and new perspectives for the design and development of novel nanomaterials for improved clinical applications.