Targeted immunomodulation for chronic diseases through advanced delivery platforms

Introduction: Controlled drug delivery systems are transforming immunomodulation by providing targeted, localized control of immune activity in chronic diseases, including autoimmunity, infection, and cancer. Unlike conventional systemic therapies that cause systemic toxicity and relapse, these platforms deliver fine-tuned immune responses through sustained, localized release to enhance efficacy while minimizing adverse effects. Areas Covered: This review explores current strategies using nanoparticles, microparticles, hydrogels, and implant technologies to achieve targeted immune suppression, activation, or tolerance across diverse applications. Controlled drug delivery systems enable precise spatial and temporal dosing to protect transplanted tissues, induce antigen-specific tolerance in autoimmune disorders, and amplify immune activation in vaccines and cancer immunotherapy. We also discuss emerging frontiers in precision immunoengineering, such as leveraging CRISPR technologies. Expert Opinion: While translational and regulatory hurdles remain, controlled delivery platforms provide a versatile framework for patient-specific immune modulation. In our Expert Opinion, we highlight their potential to reshape clinical immunotherapy by improving long-term outcomes and enabling personalized immunomodulation, while identifying translational barriers and emerging directions.