Revolutionizing high altitude cerebral edema management: nanotechnology-enabled diagnostics and targeted drug delivery

Due to the increasing commercial activities and adventure travels, millions of people visit high-altitude regions every year. A rapid increase in altitude results in high-altitude cerebral edema (HACE), an acute form of HAI characterized by altered mental status and ataxia, which necessitates immediate medical intervention to prevent patient mortality. Nevertheless, despite significant advancements in medical research and technology, the available diagnostic and therapeutic options for this disease remain limited. Currently, the accurate diagnosis of HACE relies predominantly on magnetic resonance imaging (MRI), while treatment strategies for this condition include passive descent to lower altitudes, oxygen supplementation, and pharmacological interventions. Unfortunately, these interventions are limited by their low efficacy, severe side effects, and poor availability under severe environmental conditions. Hence, alternative approaches are highly desired in the management of HACE. With the advancement of nanotechnology in theranostics, which enables more sensitive diagnosis, real-time monitoring, and targeted drug delivery, nanomedicine holds significant potential for the management of HACE. In this review, the pathological mechanism of HACE and the current theranostic options employed in clinics are described, and the potential applications and design strategy of nanomedicines for HACE management are discussed. We hope that this review can provide creative inspirations for the development of more precise, efficient, and low-side-effect theranostic alternatives for the management of HACE. This review will be of great interest to those working in materials science, nanotechnology, biomedical engineering, and translational medicine, and especially to those in military medicine and special medicine.