Biological Applications of Nanozymes in Stroke: Current Progress and Future Directions

Stroke remains one of the leading causes of disability and mortality worldwide. Its complex pathological mechanisms pose significant challenges to current clinical management. These mechanisms especially include oxidative stress, neuroinflammation, and blood–brain barrier (BBB) disruption, which manifest differently in ischemic and hemorrhagic stroke. Conventional mainstream therapies, such as intravenous thrombolysis and endovascular thrombectomy, are severely limited by narrow therapeutic time windows and ineffective counteraction of reperfusion injury, particularly in ischemic stroke. In recent years, nanozymes have garnered considerable attention. They are a class of nanomaterials with intrinsic enzyme-mimicking catalytic activities. Their high stability, multifunctionality, and tunability offer a promising therapeutic approach to overcome these limitations. This review systematically elaborates on the recent advances and mechanisms of nanozymes in the treatment of stroke. It focuses on their ability to mimic antioxidant enzymes, such as superoxide dismutase and catalase. In an ischemic stroke, nanozymes primarily scavenge excess reactive oxygen species, modulate neuroinflammation, protect BBB integrity, and promote neurovascular repair. For hemorrhagic stroke, its functions such as antioxidant, anti-inflammatory, and hematoma clearance contribute to alleviating secondary injury and promoting neurological recovery. Furthermore, this review summarizes the latest developments in multifunctional nanozyme platforms. These developments include strategies for synergistic antioxidant and thrombolytic therapy, theranostic integration, and biomimetic targeted delivery. These integrated designs demonstrate significant potential for coordinated intervention within the complex pathological network of a stroke. Despite the promising prospects, the clinical translation of nanozymes still faces challenges. These challenges are related to biosafety, targeting specificity, catalytic selectivity, and scalable production. Finally, this review outlines future directions. It points to the development of smart-responsive nanozymes, the expansion of their application to hemorrhagic strokes, and deeper mechanistic investigations as key priorities. In summary, nanozyme technology holds great potential to steer stroke therapy toward a multitarget, synergistic, and precise paradigm. It bears significant translational medical value across both major stroke subtypes.