纳米酶在上呼吸道感染中的应用：催化机制、当前证据与新兴诊疗策略。

文献信息

中文摘要

目的： 本综述评估纳米酶作为催化生物材料在上呼吸道感染（URTI）相关诊断、治疗和预防中的应用，特别关注这些应用之间证据成熟度的差异。解剖上相邻的中耳也被视为生物膜相关感染和屏障限制性局部递送的相关模型。方法：我们回顾了涉及呼吸道病原体、鼻窦疾病、咽炎、鼻内疫苗接种和中耳炎的研究。来自其他疾病模型的证据仅在其针对与上气道相关的特定材料问题时才被纳入，例如催化调节、生物膜破坏、黏液运输或局部滞留。结果：诊断应用目前拥有最强的证据基础，特别是在呼吸道病原体检测中的催化信号放大方面。相比之下，治疗证据仍然稀少且主要为临床前研究，针对URTI的直接治疗研究尤其有限。预防应用研究较少，主要以鼻内流感疫苗接种的概念验证为代表。在这些应用中，性能取决于在富含蛋白质和黏液介质中的催化活性、生物膜穿透、促氧化和抗氧化效应的控制，以及向目标解剖部位的递送。来自其他解剖部位的证据提供了有用的设计原则，但不应被解释为在URTI中有效的证据。结论：目前纳米酶应被视为可工程化的催化生物材料，而非临床上已确立的URTI抗感染平台。转化将需要在气道相关环境中具有可重复的活性、有效的位点特异性递送、适当的安全边际，以及在疾病相关模型中的验证。

英文摘要

Objective: This review evaluates nanozymes as catalytic biomaterials for upper respiratory tract infection (URTI)-related diagnosis, therapy, and prevention, with particular attention to differences in the maturity of evidence across these applications. The anatomically adjacent middle ear is also considered as a relevant model of biofilm-associated infection and barrier-limited local delivery. Methods: We reviewed studies involving respiratory pathogens, sinonasal disease, pharyngitis, intranasal vaccination, and otitis media. Evidence from other disease models was included only when it addressed a specific materials problem relevant to the upper airway, such as catalytic regulation, biofilm disruption, mucus transport, or local retention. Results: Diagnostic applications currently have the strongest evidence base, particularly for catalytic signal amplification in respiratory pathogen assays. In contrast, therapeutic evidence remains sparse and predominantly preclinical, with direct treatment studies in URTIs especially limited. Preventive applications are less extensively studied and are represented mainly by proof-of-concept intranasal influenza vaccination. Across these applications, performance depends on catalytic activity in protein- and mucus-rich media, biofilm penetration, control of pro-oxidant and antioxidant effects, and delivery to the intended anatomical site. Evidence from other anatomical sites provides useful design principles but should not be interpreted as evidence of efficacy in URTIs. Conclusion: Nanozymes should currently be regarded as engineerable catalytic biomaterials rather than clinically established anti-infective platforms for URTIs. Translation will require reproducible activity in airway-relevant environments, effective site-specific delivery, appropriate safety margins, and validation in disease-relevant models.