Myocardial infarction (MI), a form of ischemic heart disease, is characterized by high global rates of morbidity and mortality [
1]. Timely reperfusion therapy significantly reduces the acute mortality of MI, but it can also trigger a series of events that accelerate and prolong ischemic injury, putting survivors at risk for heart failure [
2]. We refer to this as MI-reperfusion injury (MI/R). During the process of MI repair, inflammation is initiated. While timely and appropriate activation of inflammation is essential for effective cardiac repair, excessive, prolonged, or dysregulated inflammation is closely linked to adverse outcomes and complications [
3–
5]. Clinical studies have also proven that anti-inflammatory treatment is beneficial for the prognosis of patients after MI [
6,
7]. However, systemic anti-inflammatory treatment has serious side effects, hindering its clinical application [
8]. We continue to need to search for new therapeutic targets and targeted delivery strategies.
CC chemokine ligand 2 (CCL2) plays a pivotal role in the regulation of inflammatory processes by binding to its receptor, CC chemokine receptor 2 (CCR2). This interaction is instrumental in drawing in and activating immune cells involved in inflammation [
9,
10]. Research has shown that CCL2/CCR2 signaling pathway is responsible for mobilizing inflammatory monocytes to the site of injury or infection [
11,
12]. Monocytes/macrophages would continuously chemotaxis to areas where CCL2 is overexpressed due to their surface CCR2 [
11,
13]. Further research indicates that CCL2 triggers the secretion of other chemokines during the acute phase of injury, promotes the release of inflammatory factors, and induces the activation and differentiation of more immune cells [
14]. Over the long term, CCL2 continuously mediates the infiltration of immune cells, exacerbating damage [
15,
16]. And the expression and functional role of CCL2 have been extensively reported in various inflammatory diseases, including MI, atherosclerosis, multiple sclerosis, rheumatoid arthritis, stroke, and nephritis [
17,
18]. Therefore, blocking the CCL2/CCR2 axis maybe a therapeutic target for treating MI and improving post-MI healing. For example, the ablation of CCL2 has demonstrated efficacy in impeding macrophage infiltration into the healing myocardial infarct, diminishing the expression levels of inflammatory cytokines, and mitigating ventricular remodeling processes subsequent to MI [
19]. And in other cardiovascular and inflammatory diseases, the genetic deficiency of either CCL2 or CCR2 leads to a significant reduction in inflammation [
18–
21]. So blocking the CCL2/CCR2 axis maybe a new therapeutic target for the treatment of MI/R. Research efforts are currently focused on small molecules and neutralizing antibodies that target the CCL2/CCR2 signaling axis [
22]; however, these agents frequently suffer from limitations in terms of specificity and
in vivo therapeutic efficacy [
23].
Small interfering RNA, also known as siRNA, hold great potential to selectively inhibit specific genes [
24,
25]. However, clinical applications of siRNA is limited by the lack of safe delivery technologies, especially for specific tissue needs [
26]. Naked RNA has a short half-life
in vivo and is easily internalized by endocytosis after entering cells, resulting in most of the siRNA payload being expelled outside the cells, with the remaining siRNA being degraded by lysosomes [
27,
28]. Moreover, there is a lack of targeting in tissue delivery, and when systemically administered siRNA, the limited target retention necessitates higher siRNA concentrations to maintain efficacy. Additionally, siRNA requires a certain amount of time to take effect, which is not conducive to the alleviation of acute inflammation [
29]. Here, we aim to design a targeted delivery platform that uses engineered macrophage membrane-modified fusogenic liposomes encapsulating mesoporous silica nanoparticles (MSNs) to deliver siRNA, thereby blocking the CCL2/CCR2 axis, reducing the infiltration of inflammatory monocytes, modulating the immune microenvironment (IME), and thus improving the repair of MI/R (Fig. S1 in Supporting information). First, we loaded siRNA
via calcium silicate sealing using MSNs because of the biological protection and carrying effectiveness of siRNA [
30].
In vivo, it can successfully shield siRNAs against deterioration. Second, macrophage migration to infarct area depends on membrane adhesion molecules and chemokine receptors such as macrophage receptor 1 (Mac1), lymphocyte function associated antigen 1 (LFA1), P-selectin glycoprotein ligand 1 (PSGL1), very late antigen 4 (VLA4) and CCR2 [
31]. Therefore, by upregulating the expression of CCR2 on the macrophage membrane through viral transfection, nanoparticles (NPs) can not only serve as a “nanonavigator” to chemotaxis to the inflammatory site of MI but also act as a “nanodecoys” to adsorb a large amount of CCL2. Then, the adhesion molecules on the macrophage membrane can also precisely target the MI area. Furthermore, we used a previously documented technique to make fusogenic liposomes [
32], the direct transport of liposome inclusions into the cytoplasm through membrane fusion circumvents their endocytosis by recipient cells [
33]. This mechanism facilitates the delivery of liposome contents straight into the cytoplasm, thereby bypassing the endocytic pathway of the recipient cell and ensuring efficient membrane fusion-mediated internalization. After the NPs are targeted to the MI injury area, the overexpress CCR2 plays an adhesive role, providing time for the siRNA to take effect. Finally, siRNA carried by the NPs is directly released into the cytoplasm of endothelial cells in the injured area through membrane fusion to silence the production of CCL2. The two work synergistically and are spatially and temporally controllable, blocking the CCL2/CCR2 axis and reducing the chemotaxis of inflammatory monocytes. Overall, this work demonstrated that the spatiotemporal regulation of NP inhibits the CCL2/CCR2 axis, reduces inflammatory cell chemotaxis, and improves MI repair, offering a comprehensive therapeutic approach for the prognosis of MI reperfusion.
As described in Result 1.1 (Supporting information), we successfully constructed the MAC
CCR2-LM-siRNA. Next, we investigated whether macrophage membranes enhance the targeting of NPs [
34], which are then internalized by inflammatory endothelial cells and cardiomyocytes. Inspired by the inherent CCR2-CCL2 signal axis, MAC
CCR2-LM-siRNA was expected to serve as a “nanonavigator”, chemotaxing to the MI site through the binding of CCR2 to CCL2. The experimental procedure is shown in Result 1.2 (Supporting information). The data showed that under inflammatory conditions, macrophage membrane decoration increased the transport of NPs through the endothelial monolayer and their tendency to reach injured endothelial cells and cardiomyocytes. Additionally, CCR2 overexpression further enhanced chemotaxis to the MI area by binding to CCL2.
Besides, macrophage influx to inflamed sites largely depends on integrin-dependent adhesion. Mac-1 and LFA-1 binding to intercellular adhesion molecule 1 (ICAM-1) is particularly vital. Notably, ICAM-1 was found to be significantly upregulated in pre-infarcted regions, coinciding with increased leukocyte infiltration [
35,
36]. Therefore, we chose to validate the adhesion factor LFA1 guide MAC
CCR2-LM-siRNA to the damaged heart by binding to ICAM-1. We investigated the interaction of MAC
CCR2-LM-siRNA with both inflamed and non-inflamed endothelial cells using flow cytometry and immunofluorescence analysis
in vitro. Both non-inflamed and inflamed human umbilical vein endothelial cells (HUVECs) were exposed to 1,19-dioctadecyl-3,3,39,39-tetramethylindodicarbocyanine perchlorate (DiD)-labeled (on liposome) LM-siRNA, MAC-LM-siRNA or MAC
CCR2-LM-siRNA for 30 min, respectively. As expected, the binding of MAC
CCR2-LM-siRNA to the inflamed HUVECs cells were significantly increased (
Figs. 1A and
B). Similar results were obtained by flow cytometry (
Figs. 1C and
D). Furthermore, pre-treatment with an anti-LFA-1 antibody markedly diminished the interaction between MAC
CCR2-LM-siRNA and inflamed HUVECs, while the binding of MAC
CCR2-LM-siRNA to non-inflammatory HUVECs was not affected (
Figs. 1A–
D). These results indicated that macrophage membranes on NP can mediate their adhesion to damaged endothelial cells, which in turn facilitates their subsequent migration to injured myocardial tissue.
Efficient delivery of siRNA into the cytoplasm is a prerequisite for their effectiveness. Therefore, we investigated the cellular internalization pathway of MAC
CCR2-LM-siRNA after selective binding to injured myocardium. To monitor MAC
CCR2-LM-siRNA incorporating dynamic process, we used DiD to label lipids and Cy5 labeled siRNA. When incubated with the HUVECs and the MAC
CCR2-LM-siRNA 0.5 h, DiD and Cy5 fluorescent signal are mainly distributed in the cell surface, showing distinct localization (
Fig. 1E). After incubation 2 h, lipid DiD red fluorescence signal mainly appear in the HUVECs surface, while siRNA Cy5 fluorescent signal evenly dispersed in the cytoplasm (
Fig. 1E, left). Next, we determine whether the internalization of siRNA can evade degradation by endosomes/lysosomes, which is crucial for the effective function of siRNA in the cytoplasm later on. We employed FAM to tag the siRNA carried by MAC
CCR2-LM-siRNA and stained the lysosomes of the recipient cells with the Lyso-Tracker Red. Confocal images revealed that scattered siRNA fluorescence signals were observed in the cytoplasm after 2 h, and lysosome tracing red staining confirmed that there was little endosome/lysosome colocalization (
Fig. 1E, right). In conclusion, after binding to recipient cells, the siRNA encapsulated within MAC
CCR2-LM-siRNA is delivered directly into the intracellular environment through membrane fusion, thereby preventing siRNA degradation by the lysosomal phagocytic system.
Following verification of MAC
CCR2-LM-siRNA cytosolic delivery and targeting capability, we evaluated whether NP was able to block the CCL2/CCR2 axis. In the area of MI injury, endothelial cells continuously secrete CCL2 [
14], which attracts a large number of inflammatory monocytes expressing CCR2 to the center of inflammation. MAC
CCR2-LM-siRNA was expected to serve as a “nanodecoys”, alleviating the inflammatory response by adsorbing CCL2. A key requirement for competition with inflammatory cells to adsorb CCL2 is the effective binding of CCR2 to CCL2. Therefore, the binding capacity of MAC
CCR2-LM-siRNA was investigated to detect the residual content of CCL2 in the supernatant using the enzyme-linked immunosorbent assay (ELISA) kit. We added a medium containing CCL2 factor to the petri dish, then added phosphate-buffered saline (PBS), LM-siRNA, MAC-LM-siRNA, and MAC
CCR2-LM-siRNA, respectively. The results showed that the absorption of CCL2 in MAC-LM-siRNA and MAC
CCR2-LM-siRNA groups was significantly increased, and the absorption of CCL2 in MAC
CCR2-LM-siRNA group was more (
Fig. 2A). Next, we assessed the ability of siRNA to silence CCL2. Inflamed HUVECs were treated with PBS, LM-siRNA, MAC-LM-siRNA, MAC
CCR2-LM-siRNA, separately for 24 h. Then, the RNA was collected to analyze the relative expression of CCL2 by reverse transcription quantitative polymerase chain reaction (RT-qPCR). As shown in
Fig. 2B, the level of CCL2 in MAC-LM-siRNA group was significantly lower than that in LM-siRNA group, but there was no significant difference between MAC-LM-siRNA group and MAC
CCR2-LM-siRNA group. This suggests that siRNA can silence CCL2 production, while overexpression CCR2 has no effect on CCL2 production. In addition, we cultured inflammatory HUVECs with PBS, LM-siRNA, MAC-LM-siRNA, and MAC
CCR2-LM-siRNA for 24, 48, and 72 h, respectively. Afterward, we collected the media, extracted the proteins, and confirmed the expression level of CCL2 using Western blot (WB). The LM-siRNA, MAC-LM-siRNA group and MAC
CCR2-LM-siRNA group all can reduce the expression of CCL2, with the MAC
CCR2-LM-siRNA group showing the most significant reduction (
Figs. 2C and
D). As well, CCL2 levels decreased notably after 48 and 72 h of treatment in the MAC
CCR2-LM-siRNA group, indicating that the effect of siRNA was sustained over time (
Figs. 2C and
D). The results showed that MAC
CCR2-LM-siRNA not only adsorb CCL2, but also silence the production of CCL2. Together, these mechanisms effectively block the CCL2/CCR2 axis, providing a sustained effect
in vitro.
Following cardiac ischemic injury, an excessive systemic influx of inflammatory monocytes can contribute to heart failure and subsequent ischemic complications [
37]. The migration of Ly6C
high inflammatory monocytes during MI/R was mediated through the CCL2/CCR2 axis [
38]. To replicate the IME observed
in vivo after cardiac ischemic injury, we developed a Transwell model. In this model, LPS-stimulated monocytes were seeded in the upper chamber to simulate inflammatory chemotaxis
in vitro (
Fig. 2G, left). Added the culture medium containing the CCL2 factor to the lower chamber, then added PBS, LM-siRNA, MAC-LM-siRNA, and MAC
CCR2-LM-siRNA for 24 h (
Fig. 2G, left). Observe the migration of monocytes under a microscope and record the number of cells at the bottom of the upper chamber. As shown in
Figs. 2E and
H, treatment with LM-siRNA not reduced monocyte migration, but both MAC-LM-siRNA and MAC
CCR2-LM-siRNA significantly reduced monocyte migration, particularly in the CCR2 overexpressing group. These results demonstrated that MAC
CCR2-LM-siRNA with high CCR2 expression can effectively adsorb CCL2, thereby inhibiting the invasion of inflammatory monocytes. Then, similarly, the upper chamber was plated with LPS-stimulated monocytes, while inflammatory stimulated HUVECs in the bottom chamber (
Fig. 2G, right), PBS, LM-siRNA, MAC-LM-siRNA and MAC
CCR2-LM-siRNA were added to the bottom chamber and incubated for 24, 48 and 72 h, respectively. As predicted, incubation with LM-siRNA, MAC-LM-siRNA and MAC
CCR2-LM-siRNA all inhibited monocyte migration, with MAC
CCR2-LM-siRNA showing the most effective suppression (
Figs. 2F and
I). Moreover, the number of monocytes continued to decrease after 48 and 72 h of MAC
CCR2-LM-siRNA treatment (
Figs. 2F and
I). This implied that MAC
CCR2-LM-siRNA may reduce recruitment of inflammatory monocytes by cutting off the CCL2/CCR2 axis through adsorbing and silencing the CCL2.
For the subsequent in vivo experiments, mice were used, purchased from Shanghai SLAC Laboratory Animal Co., Ltd. All animal procedures were approved by the Institutional Animal Care and Use Committee (IACUC) of Zhongshan Hospital, Fudan University, and complied with the relevant guidelines outlined in the "Guide for the Care and Use of Laboratory Animals" published by the National Research Council of the Institute for Laboratory Animal Research.
The prolonged circulation of MAC
CCR2-LM-siRNA is a necessary condition for its targeted capability and clinical potential
in vivo. First, the blood circulation profile of MAC
CCR2-LM-siRNA was studied. Cy5 (on siRNA) labeled LM-siRNA, or MAC
CCR2-LM-siRNA were administered intravenously to naive mice
via tail vein. As shown in Fig. S9 (Supporting information), MAC
CCR2-LM-siRNA exhibits a longer circulation time than LM-siRNA, which is important for targeting the injured heart (Fig. S9A). In addition, flow cytometry assessed leukocyte uptake of NPs. Six h following intravenous injection of LM-siRNA or MAC
CCR2-LM-siRNA, mice were euthanized, and samples of the heart, blood, liver, and spleen were harvested and processed for analysis
via flow cytometry. The findings revealed that the incorporation of macrophage membranes notably diminished the internalization of NPs by leukocytes, implying that the presence of these membranes could potentially attenuate the clearance of NPs by the mononuclear-phagocyte system (
Fig. 3A and Fig. S8 in Supporting information). After that, we constructed a MI/R mice model, and one day later, injected PBS, LM-siRNA, or MAC
CCR2-LM-siRNA (DiD labeled liposomes), then the heart was extracted at different time points (1, 3, 24 h) and observed through
ex vivo macroscopic fluorescence imaging using the
in vivo spectral imaging system (IVIS) (
Fig. 3B). The findings revealed that the accumulation of MAC
CCR2-LM-siRNA in damaged cardiac tissue significantly exceeded that of all other groups (
Fig. 3C), IVIS imaging was further employed to analyze the distribution of DiD-labeled (on liposome) NPs in other major organs of MI/R-induced mice (Fig. S9B), showing that MAC
CCR2-LM-siRNA exhibited lower liver uptake compared to LM-siRNA (Fig. S9C). Their distribution in other organs was not significantly different (Fig. S9C). Then, the heart was sectioned into 5 µm sections and stained with cardiac troponin T (cTnT), and it was found that DiD-labeled (on liposome) MAC
CCR2-LM-siRNA was predominantly localized at the interface of the infarcted and healthy myocardium 3 h after intravenous injection, whereas LM-siRNA showed minimal localization (
Figs. 3D and
E). In addition, the heart tissue underwent staining for ICAM-1 (
Fig. 3F), and subsequent analysis demonstrated a statistically significant colocalization of ICAM-1 with DiD-labeled MAC
CCR2-LM-siRNA in the MAC
CCR2-LM-siRNA group, but not in the LM-siRNA group (
Fig. 3G, Figs. S9D and E). In summary, these results indicated that MAC
CCR2-LM-siRNA has a considerable circulation time in the blood circulation of mice, and this NP exhibited preferential targeting potential to the injured heart.
After MACCCR2-LM-siRNA was recruited to the area of cardiac injury, their effects on local CCL2 in the infarcted heart were evaluated. We constructed a MI/R mice model and injected PBS, LM-siRNA,MAC-LM-siRNA and MACCCR2-LM-siRNA one day later. Then, we measured serum CCL2 concentrations. As shown in Fig. S10 (Supporting information), serum levels of CCL2 decreased in LM-siRNA, MAC-LM-siRNA and MACCCR2-LM-siRNA groups, the most pronounced reduction was detected in the MACCCR2-LM-siRNA treatment cohort (Fig. S10A).
Additionally, one day after established the MI/R mouse model, PBS, LM-siRNA, MAC-LM-siRNA and MACCCR2-LM-siRNA were injected, and after 24, 48, and 72 h, the damaged heart tissues were collected to determine CCL2 expression using WB. The LM-siRNA, MAC-LM-siRNA and MACCCR2-LM-siRNA groups all reduced CCL2 expression, while the MACCCR2-LM-siRNA groups showed the greatest reduction, and CCL2 levels continued to decrease after 48 and 72 h of treatment with MACCCR2-LM-siRNA (Figs. S10B and C), which is consistent with our in vitro results. Next, we evaluated whether MACCCR2-LM-siRNA could reduce the number of inflammatory Ly6Chigh monocytes in the infarcted heart in MI/R mice. Flow cytometry showed that the lowest number of inflammatory Ly6Chigh monocytes accumulated in the infarcted heart of mice receiving MACCCR2-LM-siRNA treatment, while LM-siRNA and MAC-LM-siRNA also reduced their recruitment, but not as effectively as MACCCR2-LM-siRNA. In addition, Ly6Chigh monocytes continued to decrease 48 and 72 h after MACCCR2-LM-siRNA injection (Figs. S10D and E). These data indicated that MACCCR2-LM-siRNA treatment markedly decreases the infiltration of inflammatory monocytes into the infarcted area. To further demonstrate this, we performed immunohistochemistry and flow cytometry experiments to evaluate the changes in macrophage infiltration at the infarcted myocardium following different NP treatments. As shown in Result 1.3 (Supporting information), the conclusions of both are consistent with those previously obtained. Furthermore, the levels of inflammatory cytokines (IL-1β and TNF-α) in heart homogenates of MI /R mice after 3 days of MACCCR2-LM-siRNA treatment was measured by ELISA to verify the efficiency of MACCCR2-LM-siRNA immuneomodulation. The results showed that MACCCR2-LM-siRNA could significantly reduce the concentrations of IL-1β and TNF-α (Fig. S10F). Moreover, MACCCR2-LM-siRNA could also significantly inhibit the production of IL-1β and TNF-α in serum compared with LM-siRNA and PBS (Fig. S12 in Supporting information). Overall, these findings have effectively proved that MACCCR2-LM-siRNA can by cutting off the CCL2/CCR2 axis to reduce inflammatory monocytes recruited, thereby regulating the IME and alleviating the inflammatory response. To further analyze the effect of NPs on systemic inflammation in MI/R mice, we performed whole-blood transcriptomic profiling of mice treated with MACCCR2-LM-siRNA and untreated MI/R negative control mice. The RNA sequencing results are presented in Result 1.4 (Supporting information).
Finally, to evaluate the cardioprotective efficacy of MAC
CCR2-LM-siRNA, echocardiographic evaluations were conducted on mice subjected to MI/R four weeks post-administration of PBS, LM-siRNA, MAC-LM-siRNA or MAC
CCR2-LM-siRNA. Echocardiography results revealed an improvement in left ventricular ejection fractions (LVEF) and fraction shortening (FS) in the MAC
CCR2-LM-siRNA group (
Figs. 4A and
B). Moreover, the LV end-systolic volume (LVEDV) and LV end-diastolic volume (LVESV) decreased most in the MAC
CCR2-LM-siRNA group compared to the other groups (
Figs. 4C and
D). The findings indicated that MAC
CCR2-LM-siRNA significantly mitigates the decline in cardiac function in mice following MI/R. Subsequently, to evaluate pathological remodeling, cardiac tissue sections were collected, and collagen volume as well as infarct area were analyzed using Masson staining (
Fig. 4E). Consistent with expectations, the MAC
CCR2-LM-siRNA group exhibited the greatest preservation of myocardium and the least fibrosis compared to the control groups (
Figs. 4F and
G). Overall, these findings confirmed that MAC
CCR2-LM-siRNA enhanced cardiac function and alleviated fibrosis in MI/R mice. In addition, the evaluation of NP safety is described in Result 1.5 (Supporting information).
In this study, we developed a CCR2-overexpressing macrophage membrane-coated lipid NP delivery system (MACCCR2-LM-siRNA) that achieves precise active targeting of siRNA to the MI/R injury site. The targeting capability stems mainly from two key features of the macrophage membrane coating. First, adhesion molecules naturally present on the macrophage membrane enable the NP to preferentially home to the inflamed myocardial tissue. Second, the overexpressed CCR2 receptors on the macrophage membrane specifically interact with the chemokine CCL2, which is highly expressed in the infarcted region, facilitating chemotaxis and accumulation of the NPs at the injury site. Importantly, CCR2 overexpression not only enhances targeting but can also adsorb excess CCL2 locally, providing an early blockade of the CCL2/CCR2 axis before siRNA-mediated gene silencing takes effect, thereby better controlling acute inflammation. Following NP accumulation, MACCCR2-LM-siRNA fuses with injured endothelial cell membranes to efficiently deliver siRNA into the cytoplasm, where it silences CCL2 expression. This suppression prevents recruitment of inflammatory monocytes to the damaged myocardial tissue, exerting a potent anti-inflammatory effect. Our results demonstrate that the MACCCR2-LM-siRNA platform integrates precise cell membrane-based targeting, local inflammation clearance, and IME remodeling to promote myocardial repair.
The significance of our work lies in the novel combination of biomimetic targeting
via macrophage membrane adhesion factors and CCR2/CCL2 axis modulation with siRNA therapy. The CCR2/CCL2 interaction is well recognized as a pivotal chemokine pathway regulating monocyte recruitment in various inflammatory contexts, including MI/R injury. Recent studies have further elucidated the critical role of this axis in orchestrating inflammatory cell infiltration and tissue remodeling after cardiac injury [
39,
40]. Our dual-targeting approach enhances delivery specificity and therapeutic efficacy by simultaneously utilizing macrophage membrane adhesion molecules and CCR2-mediated chemotaxis, thereby effectively intercepting this key inflammatory signaling. This strategy minimizes systemic immunosuppression risks by confining the intervention locally to the infarct zone. Additionally, leveraging a natural cell membrane coating improves biocompatibility and immune evasion, offering a promising therapeutic platform for nucleic acid delivery in the highly complex and dynamic inflammatory milieu.
However, there are limitations to consider. The long-term safety and pharmacokinetics of these membrane-coated NPs require rigorous evaluation. Our current findings are based on murine MI/R models, which may not fully capture the complexity of human pathophysiology, potentially affecting clinical translation. Moreover, while targeting the CCL2/CCR2 axis is effective, myocardial reperfusion injury involves multiple inflammatory pathways, suggesting that combining multi-target strategies could yield improved therapeutic outcomes.
In conclusion, our MACCCR2-LM-siRNA platform exploits macrophage membrane adhesion molecules and CCR2 overexpression to actively and specifically target inflamed myocardial tissue, facilitating efficient siRNA delivery to silence CCL2 and reduce inflammation. This study provides important insights into spatiotemporal regulation of inflammation via biomimetic nanomedicine, offering a promising avenue for treating MI/R injury and other inflammatory diseases.