Table 2:
Future research recommendations for kidney-targeting nanomedicines.
| Future research directions | Goal(s) | Rationale |
|---|---|---|
| Disease-specific models | Collaboration of nanomedicine developers, disease biologists and clinicians to utilize the most effective preclinical models | Tailored and representative models better predict clinical outcomes, improving translational likelihood [177, 181, 183] |
| Genomic therapies | Improve delivery of RNA-based or CRISPR therapeutic agents to the kidney | Substantial in vitro work has been done to develop genomic therapies, although these are difficult to translate in vivo [66] |
| Manufacturing and reproducibility | Enhance manufacturing methods of kidney-targeting nanomedicines for reduced cost and high reproducibility | Scalable and reproducible manufacturing methods are necessary during translation [34, 178, 188] |
| Improve renal targeting | Develop and optimize methods to increase kidney targeting and to selectively localize particles to cells within the kidney | Understanding targeting methodologies, including active and passive methods, can improve accumulation in target tissues and cell types, potentially improving therapeutic responses and limiting off-target interactions [201] |
| Diagnostic and theranostic development | Design nanomedicines that combine therapeutics and diagnostics for kidney disease in one platform | Integration of diagnostic methods with therapeutic agents can allow for real-time monitoring of disease progression and treatment response [37] |
| Personalized treatment | To facilitate the delivery of highly selective treatments based on a patient's mutations or disease history | Personalized treatment, based on disease type, genetics and severity, can improve patient outcomes, as progression of kidney diseases can affect the accumulation of nanoparticles |
| Degradation and safety | Ensure systems are cleared from the body to reduce long-term toxicity and understand mechanisms of clearance or degradation | Understanding particle degradation, whether by intact renal clearance or degradation, is necessary for long-term safety [38, 39] |
| Pharmacokinetic analysis | Understand the pharmacology of current kidney-targeting nanomedicine platforms to optimize | Pharmacokinetic analysis can inform design parameters and dosing strategies to optimize the therapeutic efficacy of the nanomedicine and ensure towards-the-clinic development |