Nanoantibodies: A Review of Diagnostic and Therapeutic Applications in Respiratory Diseases

BACKGROUND: Conventional monoclonal antibodies generated by hybridoma technology have long been applied in disease diagnosis and treatment, yet they are constrained by inherent limitations, including epitope loss caused by chemical antigen processing and insufficient tissue penetration. Nanobodies, as single-domain antibody fragments derived from camelids and chondrichthyans, possess unique superior physicochemical characteristics such as low molecular weight, low immunogenicity, easy modification, strong tissue permeability, and precise epitope targeting. Notably, camelid-derived nanobodies exhibit high homology with human antibody subfamilies and favorable biosafety, showing promising potential for biomedical applications. METHODS: This review systematically summarizes the unique structural properties and technical advantages of nanobodies. It comprehensively sorts out the latest research progress of nanobodies in common respiratory diseases, including asthma, tuberculosis, respiratory infections, and lung cancer, and further analyzes their unique superiority in pulmonary drug delivery and clinical transformation. RESULTS: Nanobodies retain the specific antigen-binding capacity equivalent to traditional monoclonal antibodies while overcoming the defects of conventional antibody preparations. Their excellent modifiability, tissue penetration and low immunogenicity enable them to achieve accurate targeted binding in respiratory tissues. Accumulating evidence verifies the outstanding diagnostic performance and therapeutic efficacy of nanobodies in multiple respiratory disorder models, providing new technical support for pulmonary drug delivery and precise intervention of respiratory diseases. CONCLUSION: Nanobodies possess irreplaceable advantages in the diagnosis and treatment of respiratory diseases and have broad clinical translation prospects. This review clarifies the application value of nanobodies in mainstream respiratory diseases and proposes innovative strategies for the precise diagnosis and targeted treatment of respiratory disorders, laying a theoretical foundation for further clinical transformation and in-depth application of nanobody-based respiratory therapeutics.