Macrophage Membrane-Cloaked, ROS-Triggered Quercetin Nanocarriers Target Ovarian Lesions to Treat Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) involves oxidative stress-driven ovarian dysfunction and remains difficult to treat due to drug side effects and poor target engagement. We engineered a reactive oxygen species (ROS)-responsive, macrophage-membrane-camouflaged quercetin nano-therapy (MM@PCD@QNPs) to enhance ovarian delivery and mitigate toxicity. The core comprises a pinacol phenylboronate-dextran conjugate that encapsulates quercetin and undergoes ROS-triggered release; a surface M0 macrophage membrane confers immune evasion and lesion tropism via retained proteins (e.g., CD11b and CD47-SIRPα). MM@PCD@QNPs displayed nanoscale dimensions and stability (133.63 ± 14.60 nm; −33.13 ± 1.52 mV) and released drug under elevated ROS. In DHT-injured granulosa cells and a DHEA-induced PCOS mouse model, the formulation promoted granulosa cell proliferation, suppressed apoptosis, reduced ROS, and preferentially accumulated in ovaries, with negligible in vitro and in vivo toxicity. Transcriptomics and validation implicate activation of the MAPK7-Nrf2-NQO1 axis as a principal mechanism; pharmacologic MAPK7 inhibition abrogated therapeutic effects. By coupling ROS-triggered release with macrophage-mimetic targeting, MM@PCD@QNPs overcome quercetin's low bioavailability and off-target exposure and provide a safe, effective nanoplatform for PCOS therapy.