Novel Carbon Dots Nanomaterials for the Precision Diagnosis and Treatment of Acute Lung Injury and Acute Respiratory Distress Syndrome: Mechanisms and Applications

Acute Lung Injury (ALI) and its severe manifestation, Acute Respiratory Distress Syndrome (ARDS), represent critical clinical challenges characterized by diffuse alveolar damage, uncontrolled inflammatory storms, and oxidative stress. Despite supportive therapies such as mechanical ventilation have advanced considerably, mortality rates remain persistently high. Over the past five years, Carbon Dots (CDs)-a novel class of zero-dimensional carbon nanomaterials-have demonstrated significant potential for the precision theranostics of ALI/ARDS due to their ultra-small size (<10 nm), tunable photoluminescence, superior biocompatibility, and intrinsic enzyme-mimicking activities. This review comprehensively synthesizes frontier advancements in CDs applications for pulmonary diseases over the past five years. We systematically elucidate eco-friendly synthesis strategies, surface functionalization (eg, mannose and RGD peptide targeting), and the mechanisms by which CDs function as nanozymes (mimicking SOD, CAT, and POD) to scavenge reactive oxygen species (ROS). Particular emphasis is placed on novel therapeutic strategies, including the modulation of the gut-lung axis to remodel intestinal flora and the construction of ROS-responsive smart drug delivery systems (eg, for siRNA and glucocorticoids). Furthermore, we compare the inhalation toxicology of CDs against traditional carbon materials like carbon nanotubes and evaluate their utility in in vivo lung inflammation imaging and microenvironmental sensing (NO, pH). This review aims to provide a theoretical foundation and strategic direction for the clinical translation of CD-based nanomedicine.