{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:30:24Z","timestamp":1788975024198,"version":"build-2803163510"},"reference-count":237,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012632","name":"Nazarbayev University","doi-asserted-by":"crossref","award":["211123CRP1614"],"award-info":[{"award-number":["211123CRP1614"]}],"id":[{"id":"10.13039\/501100012632","id-type":"DOI","asserted-by":"crossref"}]},{"award":["211123CRP1614"],"award-info":[{"award-number":["211123CRP1614"]}],"id":[{"id":"https:\/\/ror.org\/052bx8q98","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan","award":["AP19676272"],"award-info":[{"award-number":["AP19676272"]}]},{"name":"Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan","award":["AP26102345"],"award-info":[{"award-number":["AP26102345"]}]},{"award":["AP19676272"],"award-info":[{"award-number":["AP19676272"]}],"id":[{"id":"https:\/\/ror.org\/05tyne317","id-type":"ROR","asserted-by":"publisher"}]},{"award":["AP26102345"],"award-info":[{"award-number":["AP26102345"]}],"id":[{"id":"https:\/\/ror.org\/05tyne317","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Sepsis-induced liver failure remains a serious and often under-recognized complication of abdominal sepsis. Clinical reports suggest that liver dysfunction develops in a substantial proportion of these patients, and once failure ensues, mortality rises sharply. Despite progress in antimicrobial therapy and critical care support, there is still no therapy that directly halts or reliably reverses septic liver injury. Systemic drug administration frequently underperforms in this setting. Hepatic drug accumulation becomes unpredictable, pharmacokinetics shift, and immune dysregulation further complicates therapeutic control. Nanotechnology-based delivery systems have attempted to address these shortcomings by improving drug stability and circulation time. Yet their behavior under septic conditions remains inconsistent. This inconsistency may reflect a deeper issue: most carriers are engineered under relatively stable physiological assumptions that do not hold during systemic inflammation. Biomimetic platforms, particularly those derived from erythrocyte membranes, offer a different conceptual entry point. Rather than merely evading immune recognition, erythrocyte-based systems interact naturally with hepatic clearance pathways. During sepsis, erythrocyte turnover appears to accelerate, and macrophage-mediated clearance in the liver intensifies. This shift, while pathologic, may present a therapeutic opportunity. In this review, we examine current liver-targeted delivery strategies for sepsis-induced liver failure and critically assess the underexplored role of erythrocyte ghost-based systems. We discuss how sepsis-specific pathophysiological changes reshape carrier biodistribution, identify translational constraints, and propose design considerations for inflammation-adaptive biomimetic platforms. By reconsidering hepatic clearance not solely as a pharmacokinetic barrier but as a potential delivery route, we outline a disease-aligned approach to nanomedicine design in septic organ failure.<\/jats:p>","DOI":"10.3390\/ijms27114978","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:45:08Z","timestamp":1780404308000},"page":"4978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Biomimetic Targeted Drug Delivery for Liver Failure in Abdominal Sepsis: Focus on Autologous Erythrocyte Ghosts"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6371-9210","authenticated-orcid":false,"given":"Kulzhan","family":"Berikkhanova","sequence":"first","affiliation":[{"name":"National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"University Medical Center, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"Professor G.V. Tsoi Scientific and Educational Center of Surgery, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1384-1733","authenticated-orcid":false,"given":"Isah","family":"Inuwa","sequence":"additional","affiliation":[{"name":"National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erlan","family":"Taigulov","sequence":"additional","affiliation":[{"name":"National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"Professor G.V. Tsoi Scientific and Educational Center of Surgery, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saken","family":"Kozhakhmetov","sequence":"additional","affiliation":[{"name":"National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"Professor G.V. Tsoi Scientific and Educational Center of Surgery, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurzhan","family":"Bikhanov","sequence":"additional","affiliation":[{"name":"National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"University Medical Center, Nazarbayev University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardak","family":"Omarbekov","sequence":"additional","affiliation":[{"name":"Professor G.V. Tsoi Scientific and Educational Center of Surgery, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulsara","family":"Berikkhanova","sequence":"additional","affiliation":[{"name":"Department of Higher Mathematics, Faculty of Computer Systems and Professional Education, Saken Seifullin Kazakh Agrotechnical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yessenhan","family":"Sultan","sequence":"additional","affiliation":[{"name":"Medical Center \u201cSultan-Medicus\u201d, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2685-7305","authenticated-orcid":false,"given":"Abdulrahman Garba","family":"Jibo","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0782-1795","authenticated-orcid":false,"given":"Saniya","family":"Abdrakhmanova","sequence":"additional","affiliation":[{"name":"\u201cScientific and Production Center for Transfusiology\u201d of the Ministry of Health of the Republic of Kazakhstan, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhannat","family":"Zhakiyanova","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ophthalmology and Otorhinolaryngology, Department of Obstetrics and Gynecology named after A.A. Kozbagarov, Semey Medical University, Semey 071400, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulyash","family":"Tanysheva","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ophthalmology and Otorhinolaryngology, Department of Obstetrics and Gynecology named after A.A. Kozbagarov, Semey Medical University, Semey 071400, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaxybay","family":"Zhumadilov","sequence":"additional","affiliation":[{"name":"National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan"},{"name":"School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global; regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3390\/epidemiologia5030032","article-title":"The Global Burden of Sepsis and Septic Shock","volume":"5","author":"Sangiorgio","year":"2024","journal-title":"Epidemiologia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1186\/s13054-023-04762-6","article-title":"Targeting the host response in sepsis: Current approaches and future evidence","volume":"27","author":"Bode","year":"2023","journal-title":"Crit. 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