Trained immunity refers to a hyperresponsive functional state of the innate immune system, which is induced by certain stimuli, such as infections or vaccination. Trained immunity plays a key part in a variety of diseases, including cancer and inflammation, and is regulated through epigenetic and metabolic reprogramming of haematopoietic stem and progenitor cells in the bone marrow, giving rise to hyperactive myeloid cells. Nanomaterials inherently interact with phagocytic myeloid cells and are thus ideal platforms with which to regulate trained immunity. In this Review, we discuss the key pathways of trained immunity and investigate nanomedicine strategies to therapeutically regulate trained immunity. Nanomedicine can be applied not only to induce trained immunity to treat cancer or to enhance resistance to infections, but also to manage hyperinflammation and maladaptive trained immunity in a variety of clinical scenarios. We conclude with an outlook to future possibilities and some remaining challenges for nanomedicine approaches in trained immunity regulation.

训练有素的免疫是指先天免疫系统的高反应性功能状态，它是由某些刺激（如感染或疫苗接种）诱导的。训练有素的免疫在包括癌症和炎症在内的多种疾病中起着关键作用，并通过骨髓中造血干细胞和祖细胞的表观遗传和代谢重编程进行调节，从而产生过度活跃的骨髓细胞。纳米材料固有地与吞噬性骨髓细胞相互作用，因此是调节受过训练的免疫的理想平台。在这篇综述中，我们讨论了训练免疫的关键途径，并研究了治疗性调节训练免疫的纳米医学策略。纳米医学不仅可以用于诱导训练有素的免疫力来治疗癌症或增强对感染的抵抗力，还可以在各种临床情况下管理过度炎症和适应不良的训练免疫。最后，我们展望了未来的可能性和纳米医学方法在训练有素的免疫调节方面的一些剩余挑战。